The difficulties of changing

In general, our psychological equipment develops in such a way that we get information of predictive value through the senses; we tend to record constancies and consistencies of events and behave as though these are persistent. We are mostly unaware of the power of the stores of relevant experience (assumptions, expectations, attitudes) that condition our perceptions and therefore cannot question them, nor in many circumstances is there need to do so. In fairly constant conditions they are useful in helping us to see, quickly and effortlessly, what we expect to see. But in rapid changes this is not so; we can no longer rely on our psychological equipment and we become uncertain, confused and, in extreme cases, antagonistic, fearful and impotent. Examples of assumptions that influence medical education and medical treatment are given. Ability to respond effectively to change requires confidence to examine and restructure basic assumptions. The value of interaction in small groups in helping to achieve this is indicated.