You should inform your gut and then trust it. - Daniel Kahneman

During one of these lectures, our teacher imparted a morsel of clinical wisdom. This is what he told us: “You will from time to time meet a patient who shares a disturbing tale of multiple mistakes in his previous treatment. He has been seen by several clinicians, and all failed him. The patient can lucidly describe how his therapists misunderstood him, but he has quickly perceived that you are different. You share the same feeling, are convinced that you understand him, and will be able to help.” At this point my teacher raised his voice as he said, “Do not even think of taking on this patient! Throw him out of the office! He is most likely a psychopath and you will not be able to help him.” Many years later I learned that the teacher had warned us against psychopathic charm, and the leading authority in the study of psychopathy confirmed that the teacher’s advice was sound. The analogy to the Müller-Lyer illusion is close. What we were being taught was not how to feel about that patient. Our teacher took it for granted that the sympathy we would feel for the patient would not be under our control; it would arise from System 1. Furthermore, we were not being taught to be generally suspicious of our feelings about patients. We were told that a strong attraction to a patient with a repeated history of failed treatment is a danger sign — like the fins on the parallel lines. It is an illusion — a cognitive illusion — and I (System 2) was taught how to recognize it and advised not to believe it or act on it.

Caring for people often takes the form of concern for the quality of their stories, not for their feelings. Indeed, we can be deeply moved even by events that change the stories of people already dead. We feel pity for a man who died believing in his wife’s love for him when we hear that she had a lover for many years and stayed with her husband only for his money. We pity the husband although he had lived a happy life. We feel the humiliation of a scientist who made a discovery that was proved false after she died, although she did not feel the humiliation. Most important, we all care intensely for the narrative of our own life and very much want it to be a good story, with a decent hero.

Because we tend to be nice to other people when they please us and nasty when they do not, we are statistically punished for being nice and rewarded for being nasty.