2.3.4 Reflectie-impulsmodel

Het reflectie-Impulsmodel (Strack & Deutsch, 2004) gaat er van uit dat de mens over twee parallelle systemen beschikt om (sociaal) gedrag te reguleren: het door motivatie en emotie gestuurde impulssysteem en het meer cognitief-georienteerde reflectieve systeem. 

 

Illustratie van toepassing: bovenstaande figuur geeft aan hoe arts-patientcommunicatie wordt gereguleerd. Toelichting: Communication signals such as the communication behaviour and characteristics of a patient, are either perceived or imagined. The reflective and impulsive systems process these communication signals and elicit communication behaviour through different pathways. However, there exists a final common pathway through communication schemata to overt behaviour that may be activated by input from both systems.

In the reflective system the communication signals are processed by a conscious reasoning and  decision process. The signals are converted into meaningful information by assigning them to semantic categories. This information is appraised by further reasoning in order to establish the problem which requires a communicative response. Reasoning means that syllogistic rules are used for the transfer of truth from premises to a conclusion. The goals and the communication strategies which are available to attain the goals, are then considered. In this reasoning process other elements such as expected outcomes, knowledge, emotions, attitudes, self-efficacy and perceived social norms are also taken into consideration. The model assumes that these elements can be retrieved from the impulsive system and put under conscious control. By further reasoning a decision is made which activates appropriate communication schemata through the self-terminating mechanism of intending.

The impulsive system is conceived of as an associative memory network. If one element in this network is activated by a perceived or imagined stimulus, activation spreads to other elements in proportion to the strength of the links between the elements. The links are created if stimuli are presented or activated in close temporal or spatial proximity. The links are quite stable and change only gradually through learning. However, the impulsive system has some flexibility. It can alternate between two distinct motivational orientations towards stimuli, approach and avoidance, that guide the processing of information and the activation of behaviour.

Communication schemata are clusters of links of varying abstractness within the impulsive system. They are the mental representations of communication actions used for selecting effective and appropriate communication behaviour. If a communication schema is activated either through the reflective system or the impulsive system, the corresponding communication behaviour is executed. Activation of communication schemata through the impulsive system has great advantages for communication control since it operates fast, requires no or little cognitive effort and has a low threshold for processing incoming information which enables quick responses to subtle communication signals.

Communication schemata can be linked to concrete perceptions or experiences, but can also be linked to abstract concepts such as "breaking bad news" or "promoting adherence". Communication schemata can thereby be activated by a wide variety of situations which belong to a specified class of consultations. However, a consultation or part of a consultation must be associated first with the concerning class in the impulsive system before the appropriate schema is activated and the communication behaviour is executed. This means that the link between the characteristics of a consultation and a specified class of consultations is as important as the formation of the communication schema for this class of consultations. Otherwise, a person must fall back on the reflective system and consciously decide what communication behaviour is appropriate in the consultation at hand.

There is an asymmetry between the two systems such that the impulsive system is always engaged in processing whereas the reflective system may be disengaged. A stimulus will always be processed in the impulsive system, but the impact of the information depends to a great extent on the strength of the links between the representation of the stimulus and other elements in the system. Depending on its intensity and the attention it receives, a stimulus may also enter the reflective system and be processed through conscious reasoning and decision. The reflective system operates most efficiently at intermediate levels of arousal, while high levels of arousal facilitate well-practised, dominant responses in the impulsive system.

Nuancing in the reflective process will then be blocked and inadequate communication schemata could be triggered. The reflective system and the impulsive system can also compete if they activate incompatible schemata. Such antagonistic activation may be accompanied by a feeling of unease or even conflict which diverts attention and hampers the functioning of the reflective system. The schemata activated by the impulsive system will then prevail.