Stress Causes: Selection Bias

by Doc Orman, M.D.

This is the third and final post in a series of three related posts this week, all based upon an excellent book titled Compartments: How The Brightest, Best Trained, And Most Caring People Can Make Judgments That Are Completely And Utterly Wrong (2009) by Steven R. Feldman, MD, PhD, Professor of Dermatology, Pathology, and Public Health Sciences at Wake Forest University School of Medicine.   

In my first post in this series (Blindness, Compartments, And Groups), I gave you an overview of what this book is about and the author’s reason for writing it.  In my second post (What On Earth Were They Thinking?) I briefly discussed the first of the three main sources of conflicts (see below) that Dr. Feldman points out as commonly arising when we think about people in groups (compartments) that differ from ours: 

1.     Things we don’t see.

2.     Things we do see, but that we shouldn’t trust.

3.     How the context of our perceptions can affect the accuracy of those perceptions. 

In the final post of this three-part series, I want to focus on one particular example of the second of these main sources of human conflict—how some of the things we do see (but that are not complete) also can lead to misunderstandings and stress in our lives. 

What Is Selection Bias? 

Blindness and bias go hand in hand.  Whenever we have a biased viewpoint (about anything) our bias makes us blind to, or dismissive of, other aspects or viewpoints that might also be valid. 

For example, are Republicans really in favor of dirty air, dirty water, and massive, planet-destroying pollution?  Are Democrats really in favor of making everyone dependent upon the government and destroying big business? 

Obviously, none of these things are really true, yet our biases (and emotions) can often lead us to mistakenly believe that they are. 

There are many different types of biases that have been identified and written about extensively.  In Compartments, Dr. Feldman focuses on selection bias as a major cause of conflicts between doctors and patients, between doctors in different specialty groups, and eventually between nations and religious groups.  Of course, selection bias doesn’t just stop there.  It can also spill over into many other areas of our lives. 

Selection bias simply means that whatever we tend to focus on, or commonly experience, may not be representative of a full and complete view of reality.  For example, he points out that as a dermatologist, he only sees people with acne who have severe or advanced conditions.  This represents only a very small (and atypical) sample of the total spectrum of people who ever have acne.  So, as a specialist, he never sees the larger group of people whose acne disappears on its own or who successfully respond to treatments offered by their primary care physicians.  Thus, due to this selection bias, he only gets to see the most resistant cases, and if he uses this experience to judge the ability of primary care physicians to take care of patient with acne, he may misunderstand that “compartment” very badly, and arrive at negative conclusions about that group of doctors that are not really warranted. 

Selection Bias And The Media 

One of the best and most influential examples of selection bias, that influences our opinions, attitudes, and emotions every day, is the media.  By simply picking and choosing which stories to feature, and which stories to present to us (and which to leave out), the media regularly and necessarily engages in selection bias.  After all, they can’t be expected to report on everything of significance that happens, anywhere on the planet. 

Now the media also engages in many other types of bias (like political bias) that affects the validity and integrity of each story they do select to present to us, but that’s another issue.  But even when they do get a story right, and it is fairly and accurately reported, there still is the matter of selection bias, which never can be removed. Thus, if you consider all of the various types of biases that can, and do, come into play with the media, we always end up with a very distorted view of the world, if this is the only input we receive. 

Selection Bias And Our Personal Experiences 

One of the problems with selection bias, as opposed to other forms of bias or human blindness, is that we tend to place a high degree of credence on things we personally experience (as opposed to things we miss and therefore having no conscious awareness of). 

When we experience something firsthand in life, or even when we witness it on television or in the movies, we gain personal experiences that may seem very real and very credible to us.  However, if they result from selection bias (experiencing individual events that may not be typical of what usually happens), we can become very confident of our opinions, even though the conclusions we draw from them may be wrong. 

Media Bias, Selection Bias, And Stress 

In Compartments, Dr. Feldman focuses on the role that media bias, selection bias, and other distortions in our thinking play in causing unnecessary conflicts (and stress) in the interactions between doctors and patients, between doctors and other health care professionals, and towards the end of his book, between nations and rivaling religious groups. 

But the effects of human blindness and bias (of all types) go way beyond just these limited aspects of life alone.  They are at the root of almost every type of stress we experience, from our anger, frustration, fears and other negative emotions; to our conflicts with friends, children, spouses, and other family members; to much of our stress at work, or at school; to financial stress; to the stress of public speaking; etc. 

[easyazon-image-link asin=”1441526323″ alt=”Compartments: How the Brightest, Best Trained, and Most Caring People Can Make Judgments That are Completely and Utterly Wrong” src=”” align=”left” width=”107″ height=”160″]So, once again, if you haven’t read this little-known book, I highly recommend you purchase it.  (Click on the image to view and purchase from But don’t stop there.  Go on to learn as much as you can about how blindness plays a role in creating problems, conflicts, and stress in your life—in ways that may not be terribly obvious to you. 

I’ll do my part in trying to bring some of these aspects of blindness to your attention, by continuing to write posts for this blog and articles for my free monthly newsletter.  But you’ve got to do much of this work on your own.  And when you do find one or more blind spots that are contributing to your stress, you will need to come up with effective ways to keep these tendencies from causing unnecessary mischief in your life.

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