Daniel Kahneman (Nobel prize – 2002) used Seymour Epstein’s “dual information processing systems” (aka two selves) theory to make sense of the human decision-making he saw in his many research projects. These two systems/selves are called the rational-cognitive (or remembering) and the experiential (or experiencing) selves. The former uses concepts/ words, make causal inference through logic, and relies on memory. This is straightforward, easy-to-understand stuff. Prior to behavioral economics research, most believed we only ‘think’ this way. The experiential system, however, is more difficult to comprehend. It’s not directly understandable to our other system (i.e., the rational-cognitive) but through the decisions we make and the actions we take. It deals only in the present moment, unable to draw on memory. It uses images, not language or symbols. It makes associations, but not cause-and-effect connections. Further, it takes a holistic view not one of distinction. Epstein’s “Cognitive-Experiential Theory” (2014) does a great job of describing the differences between the two systems (see Table 1.1 in Chapter One).

The difficulty many people have in comprehending the experiencing self arises, as I see it, through the following reasons:

1. It processes sensory-perceptual experience directly, before experience becomes transformed into concepts;
2. Humans only understand through concepts—the existence of experiential/ perceptual processing has been obscured because of our reliance on language. Quite overlooked, humans possess a ‘knowing’ that appears to come directly from the processing of percepts.
3. The ease with which humans mistakenly accept the (seeming) equivalence of sensory-perceptual experience with their conceptual transforms has largely been unchallenged. Most forget that percepts, like the sight of the Grand Canyon, the smell of coffee, the sound of middle “C,” the feeling of pain, anxiety, etc. cannot be described in and of themselves. For example, saying a certain coffee smells earthy is only correlating one unnamable to another, not saying something about coffee smell per se.

Not immune to these problems, health researchers have also been co-opted into this mistaken acceptance. Perhaps by our desire to quantify and analyze research problems has blinded us to the cost of the inappropriate substitution of a concept for a percept. Fortunately, behavioral economics research has reminded us of this distinction and shown us ways to evaluate the contribution of the experiential information processing system. Using methods like experience sampling, we can also evaluate safety, efficacy and value from the point of view experiencing self. This can be carried through to health utility assessments and the calculation of “moment” (experienced) utilities, which can then be entered in to sensitivity analyses for value demonstration activities.

Additionally, the experiential information processing system/ self may be key to understanding and controlling for response shift, including placebo response. By shifting out of the rational-cognitive system’s conceptualizations, which often dwell on the negative, to only direct sensory-perceptual experience (say of pain), suffering should ease up … for no apparent outward reason. And isn’t this the hallmark of response shift and placebo response? With this new understanding, wish me luck in the US patent office’s upcoming decision about a method I’ve proposed to predict for research participants prone to these effects. A decision will come along soon. If you’d like to know more and/or support the development of my patent, please let me know.