Dangers of Home-Baked Therapy: Bias
They say a little knowledge is a dangerous thing, something I doubt many of us would dispute. When it comes to mental health its surprising how much people appear to know, especially when they have no background or specialist training in the subject. In saying this, I'm not especially banging a drum for mental health professionals, neither am I trying to undermine those who without formal knowledge undertake painstaking research to give themselves insights into a condition or disease. No, I'm thinking more about the person who is neither of these things yet they know all about your depression and what's best for it.
How do we recognize such a person? Well, sometimes they stand out a mile. Other times they hide behind pseudo-qualifications as a cover for providing advice. Yes, you can ask to see the qualifications and grill for information about professional backgrounds, but when depressed it's sometimes the case that people are only too pleased to have a sympathetic ear, someone they can lean on and seek advice from.
Trained mental health professionals may study for years learning how to work with people who are suffering a mental health problem. One of the very early lessons is the importance of what is known as systematic bias and how this can affect the way we interpret other people's behavior. The three most common of these are 1) assuming similarity 2) assuming intent 3) stereotyping. I'm briefly exploring each in order to point out a few of the most obvious dangers.
Assuming similarity, is a bias we all tend to have, but with insight, reflection and practice it becomes easier to shake off. This kind of systematic bias refers to the assumption that others have the same basic values and motives as we do, or that the reasons for the way they behave are similar to we have done, or believe we might do. For example, a person who has a background in using depression as an excuse to avoid work, may assume others have similar motives. Another example might be that their own depression, or someone they knew, resulted from an unhappy marriage or relationship(s), so they may assume this is a key component in the depression of others.
Assuming intent, refers to the bias that other people have much more control or choice over a situation than they actually have. Here's an everyday example. Imagine, going into a shop and being given the wrong change. Surely the person could have double-checked? Maybe there's a hint, or possibly more, that it was a deliberate act? If however we make an error, that's exactly what it is - an accident, an oversight. So what if we consider this in relation to depression? Might this account for the accusations sometimes put by others that you could have avoided it? That you brought it on yourself? That in bringing it upon yourself you have the gift to get yourself out of it?
Stereotyping is one of the better known biases. This relates to ignoring differences between people and clumping everyone into the same category (e.g. all bankers have their nose in the trough). One of the paradoxes about stereotyping is that people's own insights tend to be quite low, yet they recognize and even laugh about them in others. Stereotyping also relates to lack of knowledge and sometimes fear. Might this account for the reasons some people see depression as a kind of personal indulgence that only 'weak-minded' individuals get? Or that it's a woman's issue? This is the basis for snake oil treatments. You know the sort of thing: a cold morning shower followed by a stiff five mile walk will soon snap you out of it. More subtle, but equally insidious approaches might be home-baked counseling or other forms of therapy that have no evidence base and no known treatment outcome.
Having a friend or someone trusted to listen to you and support your treatment is a valuable commodity. Unfortunately there are many people who, perhaps with the best of intentions, fumble around blindly with their own preconceived ideas about the nature of depression and the best way to 'cure' it. It's quite possible that many may never do any real harm, especially in cases of very mild depression, but in influencing a person away from effective therapies they are preventing recovery.