Trust, communication, theory of mind and the social brain hypothesis: Deep explanations for what goes wrong in health care

## Purpose The purpose of the paper is to examine the deep conceptual underpinnings of trust and communication breakdowns via selected health inquiries into things that go wrong using evolutionary psychology. ## Design/methodology/approach This paper explains how this is carried out, and explores some of the adverse consequences for patient care. Evolutionary psychology provides a means of explaining important mental capacities and constructs including theory of mind and the social brain hypothesis. To have a theory of mind is to be able to read others' behaviours, linguistic and non‐verbal cues, and analyse their intentions. To have a social (or Machiavellian) brain means being able to assess, compete with and, where necessary, outwit others. In the tough and complex environment of the contemporary health setting, not too different from the Pleistocene, humans display a well‐developed theory of mind and social brains and, using mental attributes and behavioural repertoires evolved for the deep past in hunter‐gatherer bands, survive and thrive in difficult circumstances. ## Findings The paper finds that, while such behaviours cannot be justified, armed with an evolutionary approach one can predict survival mechanisms such as turf protection, competitive strategies, sending transgressors and whistleblowers to Coventry, self‐interest, and politics and tribal behaviours. ## Originality/value The paper shows that few studies examine contemporary health sector behaviours through an evolutionary psychology lens or via such deep accounts of human nature. Cover......Page 1 CONTENTS......Page 2 EDITORIAL ADVISORY BOARD......Page 5 Introduction......Page 6 Trust, communication, theory of mind and the social brain hypothesis......Page 10 Accountingization, trust and medical dilemmas......Page 25 New workforce roles in health care......Page 38 Understanding power relationships in health care networks......Page 50 Spanning boundaries in pursuit of effective knowledge sharing within networks in the NHS......Page 63 Exploring HRD in two Welsh NHS Trusts......Page 75 Policy and organizational implications of gender imbalance in the NHS......Page 89 Human resource management and performance in healthcare organisations......Page 105 Patient involvement in a professional body: reflections and commentary......Page 117 Involving the public in NHS service planning......Page 127 This e-book considers different aspects of power and how it affects and is affected by people involved in health care organization. The papers included tell a collective story, focusing variously on: trust and communication within health care encounters; adverse medical outcomes; power and new organizational types in healthcare; HRM and HRD in healthcare; and power inequalities and gender inequalities in the healthcare organization. The e-book also considers the influence of professional bodies, patients and the public, considering their importance and power in the healthcare dynamic. A must-r.