Thursday, May 5, 2016

Confirmation Bias in Marriage

There's a saying in residency: “You see what you look for. You look for what you know.”

I remember as first-years we had to come up with interesting cases to present for weekly grand rounds given for the entire body of ophthalmologic faculty, a nerve-wracking experience. We had to figure out how the knobs on a slit lamp worked while simultaneously finding something interesting to world experts, then get grilled on-stage about differentials and management. Every single week. That’s Hopkins for you. Anyway, during early morning rounds we’d pool together what cases we could find to see what passed muster for our chief resident. He was someone we looked up to as a demigod: tall and attractive, impeccably dressed, freakishly intelligent with intimidatingly high standards, but somewhat socially awkward. Terse, blunt, the opposite of nurturing or effusive. He had a way of talking without saying a word, and as we’d go through the one or two cases we could find, he’d purse his lips dismissively and ever-so-slightly shake his head.

There was always one resident in my class who’d have a list of eight or nine cases each week. We’d each be desperately trying to dig out one case, and he’d pull this long list out of his white coat pocket. Some of them were ridiculous, but more often than not he’d have one or two worth presenting. I was always dumbfounded: we worked in the same clinics; how did he end up getting all the interesting patients? Until I realized: he read. All the time. I mean, I would read about a diagnosis here or there, but he was reading thoroughly through entire ophthalmological texts. He didn’t get all the interesting patients; he just knew what to look for. Things that probably passed right under my nose.

It’s a bit like confirmation bias: we see what we expect to see, which then confirms what we expect. Some of the cases were ridiculous because he saw what he wanted to see rather than what was contextually likely, but a lot of the cases were true pick-ups of interesting findings that others would have overlooked. The point being, what we think or know shapes how and therefore what we see. To some extent, we see what we want to see.

This is especially true of marriage. In marriage you see the strange juxtaposition of someone’s most unfiltered strengths and weaknesses. No one knows better than a wife how her husband is self-sacrificial, hard-working or the like: she also knows better than anyone how he leaves his socks on the floor, or farts, or whatever. When you focus on the good things, you don’t notice the bad things as much, and sometimes they even become oddly endearing. When you think about the bad things, they seem to be everywhere.

If you think, he never knows what to do with the kids, you’ll see him getting the wrong milk cups out or putting mismatching clothes on them. If you think, he’s so untidy, you’ll notice all the times he doesn’t immediately put something back the way you would have. If you think, why does he have to zone out so much? you’ll start seeing all the times he checks something on his phone or watches shows. But if you think, he cares about us so much, you’ll notice the way he sets out breakfast bowls the night before to save you time in the morning. If you think, he serves without complaining, you’ll notice how he always drives, or changes diapers without being asked. If you think, he’s so generous, you’ll see how he never criticizes what you buy for yourself.

In a discussion about her book The Surprising Secrets of Highly Happy Marriages, Shaunti Feldhahn once spoke about how couples who are happy do one simple thing: they think the best of each other. If a husband is late for an anniversary dinner date, for example, the wife could be sitting there thinking: he’s always late. He doesn’t care about us. He always works too much. Or she could be thinking, he’s doing his best. He must believe that whatever is keeping him at work is important for both of us—and that makes her respond differently to him when he finally shows up.

On the flip side, psychologist John Gottman microanalyzed videotapes of couples talking, documenting tone of voice, facial expressions, and body movement. He found that the greatest predictor of divorce was the expression of contempt. Contempt is the end product of steadily seeing the worst in your spouse: eventually they become someone subhuman. Someone you treat in ways you wouldn’t treat a stranger on the street. As Gottman says, “it’s trying to put that person on a lower plane than you.”

I’m not suggesting turning a blind eye to real issues we need to talk and work through, but I think it’s true that who Dave becomes is often a product of the dialogue I carry on in my own head. And how I see him affects so much of who he literally becomes, since words and perceptions have so much creative power in marriage. Am I conscious of what I’m thinking? Of what I’m noticing about him and any judgments I make? What have I seen about him today for which I’m grateful? This all could apply just as easily to the kids. But that could be a whole other post.

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