Escaping the loop.
This is a story about intuition and its relation to logic.

A mother came to see me recently with her nine-year-old son, who wets his bed. She wanted me to write a letter to the council to support the family's application for a bigger flat. The boy apparently has two elder brothers who share his bedroom. They are fed up with the smell of his urine and want another bedroom.

When she made this request, I tensed up. I felt caught in a double bind. If I said no, I would probably lose any chance of helping the boy with his enuresis. If I said yes, I would effectively be offering an incentive for his behaviour.

Like most doctors when faced with this kind of dilemma, I found a solution intuitively. But afterwards I analysed what I had done and realized that it conformed rather well with formal logic and communication theory. This was a relief, as I was in the middle of preparing a seminar on this topic for a group of clinicians, and beginning to have my doubts about whether it fitted real life. I will tell you about my solution later, but …