A Norwegian therapist we know read a transcript of an American therapist's report on her work with a man with a crush injury to his hand. The report was basically a long list of abbreviations about...

A Norwegian therapist we know read a transcript of an American therapist's report on her work with a man with a crush injury to his hand. The report was basically a long list of abbreviations about DIP (Distal joint), PIP (Proximal Interphalangeal joint) and other joints and various soft-tissue injuries. This therapist looked up from the notes and sighed. We asked, ‘What is the matter?’ and she said, ‘I can just see it all now. This man is going to get very depressed, lose his job, probably become an alcoholic and his wife will divorce him. He will probably have bad contractures, more surgery, be committed to therapy for a while and cycle back and forth between depression and attempts to get his life and therapy back on track’. We looked at her in astonishment. That was exactly what happened to him. ‘How did you know?’ we asked. She said, ‘I've seen it all before. I have been a hand therapist for several years. As soon as I read the description of his injuries, his hand just lit up in my mind. I could just see it. Then his life just rolled along in my mind as well. I knew just how it was going to be. This is a very difficult injury and very devastating to the person’. This experienced therapist knew similar people in the past and was able to envision this person's situation. The strong imagistic quality, to say nothing of the accuracy, of her comments demonstrates more than simple memory. Her capacity to suddenly see this patient in her mind's eye is part of her expertise. The image is a vivid and powerful portrayal of the person's future life. This therapist's ability to create vivid images of a patient's life, to take a minimal description of a hand injury and envision a host of life consequences, including how they might affect the emotions and motives of the patient, also reveals well-developed skills in narrative reasoning.