Drop the Cortisol, add a Mulligan in Rehabilitation

In golf, a re-do is often referred to as a Mulligan. While this is common knowledge, it is not common practice and is in fact not a part of professional competition. A “do-over”, “re-do” can also be referred to as a “Fresh start” in the realms of psychology and more specifically behavioral economics.

Consider providing a free-play or fresh start to your patient experiences in rehabilitation. When announced before a task of higher skill demand or challenge, the fresh start effect can give people more room to try harder without a consequence.  Wouldn’t you be willing to give it “your all” if you new that you had another chance coming?

Therapists can provide a Mulligan when patients appear particularly internally focused or are observed to be limiting their degrees of freedom. Elevated cortisol, elevated and unhealthy levels of muscular tone, the distraction of fear, co-contraction and other elements that come with pressure can be mitigated by knowing that this attempt counts only if you want to keep it. Regardless of personality or preferences, most people benefit from the notion that they will be kept safe in this trial and that they have the permission to give it their all.

For more work on the Fresh Start effect, look to authors such as Katie Milkman, Maya Shankar, Sian Beilock, and investigations on the importance of play in rehabilitation. Hodges and Lohse, 2022, and others.