By Elliott Perkins, DC, CSCS
The sheer amount of research being conducted and published each year is astounding. We are constantly being bombarded with new information, which, as evidence-based practitioners we are then tasked with processing, understanding, and implementing in our practice. Ironically, one of the major barriers to this process is our own brain. As healthcare professionals we have received formal education guiding our clinical decision-making, but after we exit the bubble of structured education, we are on our own. We all want to make sure we don’t fall victim to the trappings of “bad science”. But what if this “bad (or, to be nicer, outdated) science” is what learned in school? What we were taught to be true, and has shaped we way we practice?
This is an uncomfortable thought.
However, being in the health and fitness field, this is reality. Our understanding of how the body works is always advancing, new therapies and methodologies are being developed, theories are being disproved and therapies becoming outdated and abandoned.
This is where the concept of “Cognitive Dissonance” enters the playing field. As we will be regularly posting articles and holding discussions regarding new research, understanding cognitive dissonance and how to “navigate” is paramount. Whenever you feel challenged in your beliefs, please feel free to refer back to this handy guide.
Cognitive Dissonance is the psychological stress humans experience when holding two or more contradicting beliefs. According to this theory, this discomfort is caused by new information clashing with our beliefs, and we try to resolve this conceptual contradiction (1).
This is not a new idea. A Theory of Cognitive Dissonance was written in 1957, after initially studying a cult who had the firm belief that the world was going to end in a flood. When the world inevitably did not end (surprise!) the members of said cult had to reconcile their belief with reality. This was exceptionally difficult for some, who had given up their homes, jobs and belongings for this belief. Needless to say, these people had a pretty bad time.
In clinical practice, some individuals have an incentive to hold fast to their beliefs. They may have financial incentive to practice a certain way, have become reliant on a certain method of delivering treatment for their livelihood, or have just held a certain belief for so long, that accepting it as incorrect would be absolutely universe shattering. And I get it. I learned certain things, believed certain things and practiced in a way that I have since changed, and it was not an easy process.
When we have this internal psychological conflict, there are two possible outcomes:
1. Reject the new idea because it didn’t conform with our previously held biases. This is called Confirmation Bias, where we seek out evidence that supports our beliefs and avoid evidence which contradicts it (2)
2. Accept the new idea, integrate it and change our beliefs and opinions
Number 1 is often easier, and therefore common. However, this is dangerous in healthcare, especially when our biases directly impact the quality of care our patients receive.
When trying to keep from falling into the trap of confirmation bias, consider the following:
Am I rejecting this idea because it doesn’t conform with my beliefs?
Is there another factor that may incentivize my beliefs? (financial, emotional, personal experience?) If so, take a second to think about that.
After removing personal factors from the equation, we can start thinking logically.
Is there solid data to support this new idea?
Has this idea been disproven or shown to be inconsistent by more in-depth research?
Has the data been peer reviewed and published in a reputable scientific journal? (i.e. not a journal that will publish anything for a fee)
Is there a biological plausibility that this idea could be true?
Key points: Don’t let yourself get stuck in the trap of only accepting that which confirms your biases. Think critically about what you learn, but be willing change with the emerging evidence.
I'll leave you with this quote from Bertrand Russell.
References:
1. Festinger, L. (1957). A Theory of Cognitive Dissonance. California: Stanford University Press.
2. Plous, Scott (1993), The Psychology of Judgment and Decision Making, p. 233