Uncertainty and The Simple-Minded

Photo Credit: Mathieu Bertrand Struck

Photo Credit: Mathieu Bertrand Struck

I’ve written in a previous post that reality keeps us from being 100% certain of any “truth”. This is why we have science and its flaming laser sword of falsifiability. But why is this such a tricky concept for humans to grasp? And what about uncertainty? Is there room for uncertainty in science? Sure! Science is very comfortable with uncertainty!

I hate politics. People seem to polarize into left and right. Why does it always have to be black and white? If you aren’t for us, then you are against us! What happened to the possibility of a third, forth, or fifth view? What happened to subtlety and nuance? This tendency is known as the false dilemma fallacy. People confirm their belief by critically assessing the opposite of their belief. It looks like this:

X is the opposite of Y.
Y is not true.
Therefore X is true.

This in no way proves “X”, but it does help the person feel certain about their belief in “X”. Turns out psychology studies have shown that people inherently dislike uncertainty. Leave something unexplained and your mind will fill the gap. There HAS to be an explanation. Since “Y” is untrue, “X” must be the answer. It is why we are so easily fooled to see patterns that are not there. You know, our old friend Type I error.

My favorite fiction author, hands down, is Neal Stephenson. There isn’t a book of his that I have not read at least twice. Every book is a mental workout that explores culture, philosophy, and science. One of the themes explored is his book The Diamond Age: Or, A Young Lady’s Illustrated Primer is that of uncertainty, ambiguity, and subtlety. The book is about the full education of a young girl named Nell. This is an interesting excerpt:

“Nell,” the Constable continued, indicating through his tone of voice that the lesson was concluding, “the difference between ignorant and educated people is that the latter know more facts. But that has nothing to do with whether they are stupid or intelligent. The difference between stupid and intelligent people—and this is true whether or not they are well-educated—is that intelligent people can handle subtlety. They are not baffled by ambiguous or even contradictory situations—in fact, they expect them and are apt to become suspicious when things seem overly straightforward.”

Later in the novel, they are discussing two groups. One group is trying to maintain the status quo, the other is trying to completely bring down society. Then the Constable challenges Nell with a dilemma:

“Which path do you intend to take, Nell?” said the Constable, sounding very interested. “Conformity or rebellion?”
“Neither one. Both ways are simple-minded – they are only for people who cannot cope with contradiction and ambiguity.”

Ah. I couldn’t put it better. This proposed dilemma is an easy trap but it is imagined.  I see this similar thing happen a lot in PT discussions:

Do you use hands on treatments or do you use passive electro-modalities?

Do you use manual therapy solely for its non-specific effects or do you use it because you believe there are specific effects yet to be found?

Is hip weakness the cause of all patellofemoral pain or is it not?

Or as my friend JW Matheson likes to ask me mockingly, “ERIK, IS THIS A GOOD THING OR A BAD THING???” How about none of the above? Maybe both options are wrong. Maybe the answer is somewhere in between. Maybe we are still uncertain.

Hey Erik! Since there is uncertainty, it means we can do whatever we want as long as it “makes sense”, right? How do we know anything???

*Sigh* No. Science doesn’t work like that. Big concepts are never black and white. They are complicated. However dichotomous (black and white) questions do exist, but they are are extremely focused and are not intuitive. It takes a lot of work to strip all of the other possible options away. Once you have that question identified, you can test the hypothesis through experimentation. (Side note: If your hypothesis cannot get to a dichotomous question that can be tested, you have pseudoscience!) At this point, something fascinating happens…

When one question is answered, it unlocks several more questions! Science never concludes. The more we know, the more questions we develop. It is like dividing a number by two again and again and again – it just goes on and on.

That does not mean that you should go ahead and fill in all the blanks with your own beliefs, it means that you need to be aware that there will always be uncertainty. Unless you are simple-minded, you should be okay with that.

UPDATE: Take note of the comment that I made above regarding pseudoscience. When you can’t create a black and white question that can be tested, you will forever be uncertain. When faced with this real dilemma, science errs on the side of doubt, not belief.