Mirror-thinking effect in health care
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
Another misinterpretation is pseudo-narcissism. This can arise when a high-contextual patient/client is assessed by a low-contextual health care provider.
- The patient/client speaks with nuance, uses implicit signals, and makes many connections. Or he/she uses humor/sarcasm that the health care provider does not understand at all.
- The health care provider expects concrete and direct language.
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
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.
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.
Health care provider A automatically assumes this is due to a traumatic experience in childhood, as the mother showed severe borderline traits. Health care provider B, on the other hand, sees a possible hereditary link between borderline and low-contextuality, and suspects that the patient/client is low-contextual themselves.
This second health care provider refers the patient/client to a multidisciplinary center for diagnosis. There she is diagnosed with 'autism'.
This shows how the same complaints can be interpreted from different perspectives: trauma versus contextual thinking. The mirror-thinking effect can lead to one healthcare provider projecting their own assumptions, while the other takes into account differences in thinking style.
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.