DR. JOHN'S CASE NOTES : ABOULOMANIA

" My partner respects , he respects me not, he respects me , he respects me not..."  could certainly be the mantra of bridge players who unfortunately suffer from this generally unknown mental disorder , both characterised and epitomised by crippling indecision. 
Many eminent psychoanalysts , such as myself , define this affliction as " the paralysis of the mind ".  Indeed , a staggeringly high proportion of slow players are diagnosed with this particular disorder known as aboulomania. Sufferers will ,  before the bridge event gets underway , appear mentally alert and sharp in all aspects of analysis and problem solving. However , as soon as they sit down at the table their brains turn to mush. The ability to make quick decisions completely disappears. Even when faced with simple easy choices like which way to take a finesse,  which card to discard , or how many rounds of trumps should be taken, 
they run into a major psychological block. They become overwhelmed by anxiety and indecision. Once they become aware of the growing impatience and disbelief of others at the time , the more they get anxious . Then , inevitably , paralysis of the mental function sets in.
Most sufferers say their incapacity or chronic indecision originates from the need to be a 100% certain. Hence the sufferer can become paralysed in his/her inability to make a decision even when probabilities of success are as high as 90%. The mere fact that a finesse through North is almost certain to work , the nagging doubt.... that on this occasion the 10 % option of taking the finesse through South should be the one to take ....will slowly but surely eat mercilessly away at their confidence. A sufferer will become paralysed by the fear that to reject the outside 1-to-10 chance is the very choice which was destined to be successful. Experience tells them that going with the odds doesn't always work out. So what in God's name should they do ?
So imagine what it is like for a victim of aboulomania to find himself facing several choices , such as which suit to make an opening lead from , and which card to pick ? The sheer scale and magnitude of the choices involved will send the player into the think tank for an indeterminable length of time. Racked with crippling indecision , hesitancy and despair will be deeply etched on his distorted and twisted face. Doubting each and every considered option , nothing ever emerges from his hand. The agony of those looking on only intensifies his inability to arrive at a decision. So when at last a card does emerge from his hand , it is quickly withdrawn and put back with the others. Sometimes aboulomania manifests itself with complete paralysis of movement , self-induced sleep and comatose-like trances.
Sadly , there is no cure, because even though there are a vast range of treatments available , sufferers seem completely unable to decide on which one to choose.