Mental Myopia

As a young doctor in Vienna, Ignasz Semmelweis observed that the habit of washing hands by the medical staff significantly decreased the mortality rate of women giving birth in the Vienna hospital. Since bacteria would be discovered by Louis Pasteur only decades later, he was unable to scientifically explain his findings and as a result was scorned by the established medical community. Instead of eternal fame, his standing amongst his peers literally washed away. He spent the last weeks of his tragic life in a mental hospital, driven mad by his inability to instill simple medical habits to save many lives. Instead of a towering giant of human ingenuity and advancement, he became an ignominious footnote in the history books.

The Semmelweis Reflex

The Semmelweis Reflex is a metaphor for the rejection of new knowledge because it contradicts existing norms, beliefs, or paradigms. It’s a form of mental myopia that can spell doom, even for the most successful organizations. Take, for instance, one of the paradigms of the financial industry. The dominant idea for success in the stock market has always been the ability to pick the right stocks and time the market. This explains the popularity of hedge funds, CNBC and celebrity mutual fund managers.

What if picking the right stocks and timing the market is governed much more by luck than skill? It would mean that investing success is driven by simply buying and holding a diversified indexed stock portfolio for a long time. Case in point: Fidelity’s recent research on stock investment success says that stock management is the biggest cause of stock investing underperformance. They actually found that people who had forgotten they had opened a stock investment account in the past, did second best. Those who had opened an investment account and didn’t touch it because they had died, did the best….


What can leaders do to balance healthy skepticism to wild claims on the one hand and the Semmelweis reflex on the other hand? While it’s hard to recognize our own inaccurate thinking, we can easily spot this flaw in others.

One of the most powerful ways to combat fatal thinking fallacies is therefore to invite the perspective from others by conducting a pre-mortem to determine causes of failure up front. Failure often occurs because of what we think we know that simply isn’t true. These flawed thoughts are known as assumptions, and they often cause new strategies and great companies to crash and burn. Conducting a pre-mortem will help you avoid falling in this trap. A pre-mortem is the opposite of a strategy post-mortem.

A post-mortem identifies mistakes after a strategy has failed. In a pre-mortem, however, you identify the major causes of failure in a creative way before the new strategy is implemented by imagining the strategy has already failed. This exercise enables you to anticipate roadblocks beforehand and significantly increase the success rate of your endeavor.

Steps to conduct a Pre-Mortem

Here is how I usually run a quick pre-mortem team exercise to overcome mental myopia in strategy setting:

  • Imagine five years in the future. Your strategy has failed so miserably that you’ve been asked for an interview by the Harvard Business Review to talk about the reasons for your spectacular failure.
  • The participants divide into small subgroups to discuss what would be said in this interview.
  • All subgroups then report on their insights. The total feedback will give a clear picture of the main business risks. Steps to mitigate these risks can then be incorporated into the strategy from the start.

If you conduct a pre-mortem with a group of external subject experts, you will also quickly identify not only the main risks, but also the hidden opportunities. This knowledge will often be a great eye opener and will be invaluable to almost guarantee success.

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