In manual therapy, listening and observation are fundamental pillars in establishing a relationship of trust with our patient-clients and providing them with the best possible support. But did you know that, just like them, we are influenced by cognitive biases? These mechanisms, often unconscious, can alter our perception, our judgment and the quality of our decisions. They impact the way we interpret information or interact with others. For manual therapy professionals, understanding these biases and how they work is an essential step in refining their practice and avoiding the pitfalls of subjectivity.
| Contents What is a cognitive bias? Categories of cognitive biases Concrete example｜the hypothesis confirmation bias How to reduce the impact of cognitive biases in manual therapy? Cognitive biases: a lever for better practice |
What is cognitive bias?
A cognitive bias is a systematic deviation in the way we process information, moving us away from logical or rational thinking. These biases, often unconscious, influence our perceptions, judgments and decisions. These biases are the result of several factors: our cognitive limitations, social influences and evolutionary automatisms.
Our brains often prefer quick, approximate answers, because they require less mental effort than more time-consuming, in-depth analyses. While these mental shortcuts are useful in certain situations requiring quick decisions, they can lead us astray in more complex contexts, such as when managing a patient-client in manual therapy.
Categories of cognitive bias
Cognitive biases fall into several categories, depending on the areas they impact. Here are the main ones:
- Memory bias: refers to distortions in the way we remember information.
Example: The recency effect, where the latest information is better remembered (better recall of the speech given by the last patient-client of the day).
- Judgmental biases: related to our assessments and may lead to incorrect judgments.
Example: Contrast bias, where the perception of a sensation is influenced by comparison with a previous sensation (a gentle massage may seem lighter after intense pressure).
- Logical biases: affect our reasoning and conclusions.
Example: Confirmation bias, where we only retain information that confirms our initial hypotheses (e.g. focusing on all the negative words of a patient-client we think is suffering from depression).
- Personality biases: linked to our character traits or beliefs.
Example: Optimism bias, where risks are deemed less likely to happen to us than to others (underestimating pain or the persistence of a chronic problem in a patient-client).
Concrete example｜the hypothesis confirmation bias
Let’s imagine that a patient-client presents with chronic back pain, and that the therapist immediately associates this pain with poor posture observed during the consultation. Convinced by this hypothesis, the therapist focuses his attention on elements that confirm this idea (such as a slight asymmetry in posture) and neglects clues that might suggest another cause, such as psychological stress or a visceral problem.
This confirmation bias can lead to hasty conclusions and less relevant interventions for the patient-client. To counter this pitfall, it’s crucial to adopt a systematic approach: ask open-ended questions, actively seek evidence that invalidates our initial hypothesis, and regularly reassess the diagnosis in the light of new information.
How can we reduce the impact of cognitive bias in manual therapy?
Here are some strategies for limiting the influence of cognitive bias in your practice:
- Taking a step back: Note your first impressions and check their validity in the light of the facts gathered throughout the session.
- Ask a variety of questions: Ask questions that explore several avenues. For example, ask “What makes your pain worse?” but also “What relieves it?”.
- Exchange with peers: Share your observations with other professionals to benefit from different points of view.
- Continuous training: Understand the mechanisms of cognitive biases so you can spot them more easily, both in yourself and in your patient-clients.
Cognitive biases: a lever for better practice
In manual therapy, awareness of cognitive biases can improve not only our practice, but also our relationship with our patient-clients. By understanding that our brains, like theirs, are sometimes trapped by mental shortcuts, we can develop a more nuanced and open approach. This strengthens the quality of the care we offer, making it more personalized, objective and effective.
By taking the time to explore and deconstruct our own biases, we become not only better therapists, but also more empathetic guides in the healing journey of our patient-clients.
To remember:
- Cognitive biases can alter our perception and judgments in our everyday lives, and even in our manual therapy practice.
- They are the result of cognitive limitations and evolving automatisms to process incoming information more quickly.
- Awareness of their existence allows us to step back and recognize the importance of exchange with peers, to base ourselves on objective tools, and to re-evaluate our initial assumptions.
Sources :
- Berthet, V. and Autissier, D. (2021). Introduction. The importance of cognitive biases in everyday life. Stop decision errors! Knowing and managing cognitive biases with the Cognitive Bias Inventory (CBI) ( p. 6 -10 ). EMS Éditions. https://shs.cairn.info/stop-aux-erreurs-de-decision–9782376874355-page-6?lang=fr.
- Burnett, D. (2017). The brain, that fool. Terra Nova.
- Postel-Vinay, O. (2023). Can we guard against our cognitive biases? Books – L’actualité À La Lumière Des Livres, 8.
