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Mindful : February 2015
Often our vision of what’s right and real gets skewed by cognitive bias, when our brains reach the wrong conclusions. In psychotherapy, Sharon Begley warns, cognitive bias can make ineffective treatments appear successful, putting patients’ recovery at risk. A throng of psychologists listens in rapt attention. The speaker declares that psychotherapies don’t require systematic study—akin to the clinical trials that determine the efficacy of drugs—because psychologists can see whether clients are improving. Thun- derous applause. And when the speaker, rising to his theme, asks how many have seen their clients improve after therapy, it’s as if he’s asked who wants a free trip to Pa ris: a sea of hands shoots into the air. The confident psycholo- gists could well be right about their healing abilities. But Scott Lilienfeld wonders. A research psychologist at Emory University, Lil- ienfeld has written papers on the resista nce of clinical psychologists—practitioners who treat depression, social phobia, marital troubles, personality disorders, and the whole woeful litany of human mental miseries—to evidence-based practice, in which the choice of treat- ment is guided by rigorous, large-scale studies. Whenever Lilienfeld advocates this, the blowback is immediate: We know what works; we see it every time a satisfied client leaves therapy cured of what troubled her. As one therapist wrote, “When treatments work, the condition being treated vanishes, and we don’t need randomized controlled trials to see this happening.” A journal editor once suggested Lilienfeld and some of his colleag ues explore why psychologists a re so adamant that they know what works. What they came up with is on a par with the cobbler’s barefoot children a nd the auto mechanic’s chronically stalling car: Psychologists— experts on the human mind— ca n succumb to cognitive biases, some of the most basic flaws in reasoning, including hindsight bias (“I knew all along you’d cheat on me”) a nd post-purchase rationalization (“I love Windows Vista; I paid $1,200 for that computer!”). → Flawed Thinking 18 mindful February 2015 Illustration by Sébastien Thibault brain science Sharon Begley is the senior health and science correspondent at Reuters, author of Train Your Mind, Change Your Brain, and coauthor with Richard Davidson of The Emotional Life of Your Brain.