The problem with explaining symptoms: The origin of biases in causal processing

Abstract

Understanding causation is complex, especially where it involves ‘the person’. Advances in physiological, psychosocial understanding and associated health interventions have nevertheless been made despite this complexity, but often in the face of a weak comprehension of the actual causal framework of any particular disorder. One of the problems highlighted by the CauseHealth Initiative and the European Society for Person Centered Healthcare is that our tools (e.g., the Scientific Method, Evidence-Based Medicine, Randomised Controlled Trials) are disappointingly weak in comparison with the model of understanding to which we aspire. Research from experimental psychology highlights a further constraint to our understanding; all animals have evolved neural mechanisms that solve natural causation in a manner that is similar to the scientific method. Our behaviour and thinking suffers from the same weaknesses as our methods. We will discuss experiments that have been conducted to test causal perceptions and mental representations. We address (1) a primary route for how causes are extracted from experience (2) the single cause bias and (3) representational complexity. These experiments have implications for both patient and practitioner as well as how they interact. Not only is the world more complex than we generally tend to acknowledge, but we have evolved to think more simply than we might wish.