Published: 26/05/2005, Volume II5, No. 5957 Page 36
Sylvia Nasar's book A Beautiful Mind, and the movie based on it, led to popular interest in the mathematician John Nash. One of his major contributions, game theory, has long found applications in economics and business, particularly in negotiation, but is not to be found in NHS training.
Mihaly Csikszentmihalyi, a psychologist who has specialised in how to be happy at work, notes: 'The more a job resembles a game - with variety, appropriate and flexible challenges, clear goals and immediate feedback - the more enjoyable it will be.' Understanding game theory is important because events in healthcare often unfold like games. Understanding the concept of sacrifice in chess - giving up a piece to put yourself in a better position at a later point - prepares you for strategies in which individuals will apparently suffer a defeat or unacceptable consequences to achieve a desired outcome in the longer term.
Similarly, sacrifices made with no clear strategy weaken you and aid your opponent.
The primary insight of game theory is the importance of focusing on others:
allocentrism. Most losers of games have an overly egocentric view; they evaluate too much from the perspective of their own position.
To look forward and reason backward, you have to put yourself in the shoes of other players.
Chess is different to poker in that all the pieces are visible. There is no subterfuge, unlike poker where it is inherent because your opponent's cards are hidden. Uncertainty creeps into the game in a way it doesn't in chess.
It is precisely this element of uncertainty that makes the bluff, threat and deception of poker closer to the game of life and work.
Von Neumann and Morgenstern, in their seminal work Theory of Games and Economic Behaviour, devote a whole chapter to poker. Their modelling shows the best strategy is not, as is commonly assumed, to feign strength while holding a weak hand - the classic bluff - but instead for your opponent to assume weakness in your position, when in fact you are hiding strength.
Dr Raj Persaud is consultant psychiatrist at South London and Maudsley trust and Gresham professor for public understanding of psychiatry.