Mirror-thinking effect in health care

The mirror-thinking effect is the tendency to assume that the other person thinks like yourself. In mental health care, this can lead to major pitfalls.

Pitfall: projection of thinking style

Health care provider highly contextual → thinks that patient/client is also highly contextual.
When this is not the case, divergent or literal thinking is sometimes misinterpreted as a result of trauma.
Health care provider lowly contextual → expects linear and literal thinking from the patient/client.
When the patient/client thinks highly contextual, their nuance or indirect communication can be misunderstood.

Low-contextual ≠ trauma

A specific pitfall is that low-contextual thinking is often confused with trauma.

A patient/client who communicates very literally and is detail-oriented can be seen by a highly contextual health care provider as someone who thinks "abnormally" due to a traumatic experience.
In reality, this can arise from a structural difference in context sensitivity, and therefore have nothing to do with trauma suffered.

Pseudo-narcisme

Een andere misinterpretatie is pseudo-narcisme. Dit kan ontstaan wanneer een hoog-contextuele patiënt/cliënt wordt beoordeeld door een laag-contextuele zorgverlener.

De patiënt/cliënt spreekt genuanceerd, gebruikt impliciete signalen en legt veel verbanden. Of hij/zij gebruikt humor/sarcasme die de zorgverlener totaal niet begrijpt.
De zorgverlener verwacht concreet en direct taalgebruik.

The result: the patient/client appears circuitous or self-absorbed, which can be incorrectly interpreted as narcissism. In reality, this is a difference in thinking style, not a personality disorder.

Examples

Casus

A patient/client says very concretely: “I hear a sound at night and wake up.”

The highly contextual health care provider expects nuance and thinks: “This must be a trauma, he associates sounds with bad experiences.” But in reality, the patient/client is just literally describing what is happening.

The wrong interpretation can lead to an unnecessary trauma diagnosis.

Casus

A man forgets to close the bedroom door late in the evening when he went to get water. He had estimated that this would be for a short duration (bathroom right next to the bedroom, everyone in the house is asleep).

For his girlfriend (low-contextual) this is unacceptable: the door was open = proof that he is disrespectful and doesn't truly love her. She reacts with extreme statements ("you are a creep", "I hate you"), without regard for the context or his intention.

The man (high-contextual) remains calm, apologizes, and explains that it was a mistake that says nothing about his love or care. He tries to put the situation into perspective, but his nuance does not reach her.

Suppose this couple enters therapy with a low-contextual therapist: they may find the girlfriend's explanation convincing ("the door was open, so he is wrong"). This confirms the girlfriend's rigidity, and the man feels even more misunderstood.

This example shows how differences in context sensitivity can lead to serious misunderstandings, and how the mirror-thinking effect can also be a pitfall for therapists.

Casus

{{{1}}}

Conclusion

The mirror-thinking effect is a structural pitfall in mental health care. By being aware of differences in context sensitivity, health care providers can avoid normal varying thinking styles being wrongly seen as pathological or trauma-related.