Barely Hanging On? Count Backwards to Success

The explosion came from out of nowhere. Flames surround me. I couldn’t see through the glowing white light of burning magnesium.

That’s how the “second half” of Dan Ariely’s life began.  After sustaining third degree burns to over 70% of his body during that magnesium explosion, Dan had years of painful recovery to look forward to, that is if he could make it through the excruciating treatments required to save his life.

Dan, now a behavioral economist, bestselling author of two books, and head of the fittingly titled Center for Advanced Hindsight at Duke, shares many insights in his harrowing account of hospital life as a burn victim, particularly on the subject of pain management.  One that I found most interesting was the use of the countdown.

Excruciating Pain

After the accident, Dan’s arm began to swell to the point that the tissue was cutting off the circulation to his hand.  The swelling was so bad that most of the surgeons wanted to amputate the arm.  Instead, one physician decided to make a series of shoulder-to-wrist incisions, to literally bleed the arm, in order to reduce the pressure.  Because of Dan’s weakened heart and lungs, the cuts had to be made without anesthesia of any kind.  The pain was so Dan was screaming, crying, and pleading with the physician to stop. Then Dan receives some encouraging news:

He tells me to count to 10 and that when I reach 10 it will be over. I start counting as slowly as I could bear. 1, 2, 3… Time seems to slow down. The pain captures every aspect of my being. All I have is the slow counting. 4, 5, 6… The pain moves up and down my arm as a new incision was made. 7, 8, 9… I still remember the tearing flesh, the excruciating anguish, and the waiting… as long as I could… before yelling… TEN!

They stop. I feel like an ancient warrior confronting his suffering with brave nobility. I also feel exhausted. “Very good,” the physician congratulates me.

Later, Dan reasoned that knowing that a treatment would end a specified point not only reduced the patient’s overall pain, but prolonged the period of time the treatment could be endured.  Dan also said that the knowledge of the end point provided some feeling of control, even though he surely had none in this instance, and reduced fear and dread, both of which were tremendous benefits.

To test this theory, Dan later asked 60 gym-goers to hold, using their dominant hand, a 5 pound weight, with their arm outstretched to the side of their body, weight parallel to the floor, until exhaustion.  Once this time was recorded, Dan asked each participant to perform the same test with their non-dominant hand, but to do it for 30 seconds longer than they did with their dominant hand.  To one group, Dan said nothing.  To the second group, Dan counted up from 0-30 after they had reached the dominant-hand time.  To the third group, Dan counted down from 30-0 after they had reached the dominant-hand time.

The first group failed, holding the weight for less time in their weak hand than they could with their dominant hand.  The up-counting group held the weight in their weak for 5 seconds longer than they did with their dominant hand.  But the down-counting group held the weight in their weak hand 25 seconds longer!

Waiting For The Subway

The use of the countdown isn’t limited to pain management.  If you live in a city with a subway, chances are you’ve seen signs installed within the last few years that display the ETA of the next train.  These were installed for much the same reason Dan’s physician had him count to ten: they make the pain more bearable.  Waiting for the subway isn’t quite as bad is surgery without anesthetic, but in some cities it’s close.  Why does the knowledge make such a difference?

In 1996, two Hong Kong researches determined that, when customers learned of the wait time, they actually overestimated what that wait would be like to endure.  This added feeling of control has a huge positive effect on customer satisfaction.


Countdowns are effective mind hacks.  Whether it’s an egg timer or a calendar, use a countdown system to help you reach your goals, especially if you’re having trouble meeting them. 

If you provide a customer experience that involves a lot of waiting, or your phone center leaves people on hold forever, and for some reason you don’t want to do anything about these problems, at least use a countdown.  You almost certainly won’t lose as many customers.

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