Why people can’t accept let alone search for the truth, even if it would save their lives.
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Believe me, this has a lot to do with why Jack Nicholson is who he is, and why I am the Renegade Doctor. That is why I can do a course adjustment and know that I have learned that an enormous amount of what I have learned in my medical education is just plain not so.
How does a bad politician differ from a good scientist? When politicians change their course, they Flip-Flop. When scientists change their course, it means they have new data.
People just don’t act as if they are looking for the truth. The first thing I learned in high school debating seemed paradoxical and weird” at first, but now I know it is totally spot on. I was told I could never debate an assertion rationally if I could not admit the assertion could be wrong. Amazing how high school stays with you for life.
Flash forward to a patient and his wife fighting in my office with each repeating verbatim (quite angrily) conflicting assertions each consistent with the position of a major political party. They could not let me give them any of the basic marital therapy they desperately needed. I am as apolitical as can be, and thought the only possibility was to leave my office and end the session for the day. Their response was to turn on me and question my Americanism/patriotism. After taking a few deep breaths, I explained I was a U.S. veteran (former Captain Goldstein M.D of the U.S. Army medical Corps) and had put my life on the line to defend their right to have conflicting beliefs.
People are studying this sort of thing more frequently than in the past, trying to explain anger like the anger that entered my office that day. One thing we know to be true — many patients over the years have told me they consider themselves to be “rational” or “logical” or “reasonable” human beings. The ones who say that have often been people in the military or academics. Me — I know nobody really is.
I mean, I have always considered myself emotionally hypersensitive. I hold it together, always, a testament to the stability of my ideal (no prejudices there) marital relationship. The truth of the matter is that most decisions are made emotionally, what most people think is “rational” is really rationalizing the decision already made by their emotions.
Belief is the biggest power that exists in the world. It makes things happen, generates emotional response — and generates reality. In psychiatry, the “self-fulfilling prophecy.” This simply means that what you believe life is going to be like is exactly what your life becomes. Too many examples to cite.
My favorite one is obvious: When I was a low-level lackey at a major hospital emergency room, and they laughed at me when I said I would become a doctor. Well, here I am, and I am not the only one who thinks I am a pretty darn good one.
Everybody clutches to their heart what they have come to believe in, and kicks out information that would topple their personal world. Your character, your identity, is the sum-total of your beliefs. You go to the ones that define you, kick out the ones that do not, and figure out the arguments later. I have learned this one the hard way. Trying to change a dysfunctional belief is generally a suicidal mission for a psychiatrist. It’s like the old joke about a psychiatrist changing a light bulb. The light bulb has to want to change.
Every time I hear this from another academic discipline, it is deja vu all over again. First there were the analysts who told me how hard it was to make people change, because of this. Then my early psychiatric patients,sometimes had suboptimal outcomes, like the one young lady whom I dismissed from hospital and came back a week later suicidal again. A caring supervisor worked very hard to convince me that I had worked perfectly,– with a woman who could not manage to believe her life could ever be better than the miserable life her mother had.
Me, I bonded with my own mother of blessed memory when we raided the refrigerator for sweets in the middle of the night, and she assured me, cuddling, that I was her daughter all right and she would always love me because we could both be fat together forever. I had to realize that was wrong, and lose any idea of any veracity gleaned from that moment.
It’s a little better now. I have some lovely techniques to help people change, if they have even the most minmal feel of comfort or frustration. One lovely source telling us especially that the hardest thing in the world to believe just might be science.
“A MAN WITH A CONVICTION is a hard man to change. Tell him you disagree and he turns away. Show him facts or figures and he questions your sources. Appeal to logic and he fails to see your point.” —Stanford University psychologist Leon Festinger
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