Be aware of how you judge


If we’re being honest, we all make judgements about the people we meet, often instantaneously.  Perhaps this stems from an evolutionary perspective of safety – needing to judge quickly our environment and the potential threat of those within it. This rapid decision is made for both parties when a patient walks into a therapist’s room. We need to be aware of our internal biases and what drives our belief in the authenticity of someone’s pain. An important consideration, as it is likely to effect treatment.

But are you really in pain?

Therapists suspicion of their patient’s pain is not new. Perhaps it’s a result of exposure. If you work in healthcare your likely to have a lower estimate of someone’s pain, compared to those outside the industry. More so, the longer you work within the healthcare industry. It seems that for some reason, we become cynical over time.

Why we doubt

Ethnicity, skin colour, sex, age, attractiveness, likeability, manner all seem to have an effect how we judge someone else’s pain. Even the absence of medical evidence makes us doubt our patient’s credibility when they tell us they’re in pain – a sad fact, especially as we learn more about the poor correlation of imaging reports and pain. Of course pain is subjective, to be felt and expressed only by the person experiencing it. Despite this, we judge, we agree, and sometimes we doubt.

Women at a disadvantage

Our judgements about pain are not equal for men and women. Clinical studies suggest that women’s pain is underestimated compared to men’s. Schafer et al. (2016) found similar results, such that “women, particularly those rated of low trustworthiness, were estimated to have less pain and to be more likely to exaggerate it.” The fear is that this trickles into clinical decisions where women receive less analgesia, and instead have their pain attributed to psychological rather than medical problems. As Schafer et al. (2016) concludes, “systematic disadvantage to women showing pain is of serious concern in healthcare settings.” Perhaps having an awareness of our biases is a good place to start.


– Hayley Leake

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