Stress Causes: What On Earth Were They Thinking?

by Doc Orman, M.D.

[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″]In my first post this week, I introduced you to an eye-opening little book 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.  (Click on image to view and purchase this book from

I also explained that Dr. Feldman identifies three main sources of conflicts that arise 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 this second of three posts this week’s on this topic, I will focus on just a few examples of the first of these sources—how things we don’t see about other people can cause us (often unnecessarily) to end up (emotionally) in conflict with them. 

Cortisone, Tachyphylaxis, And Skin Conditions 

Compartments:  Doctors (Dermatologists) vs. Patients (With Skin Conditions) 

Dr. Feldman starts off his book with a simple example that’s not too emotionally charged.  In 1948, the medicine cortisone was developed.  In the 1950’s, cortisone became available in topical cream forms that could be applied directly to the skin. It rapidly became accepted as a new treatment for certain skin problems, often with dramatic improvements.  

Once doctors became enthusiastic about using this new treatment, a problem emerged.  Repeated, long-term use of these topical medications seemed to result in loss of effectiveness.  In other words, the medicine stopped working after a certain period of time. In medical terminology, this is known as tachyphylaxis, and it is a well-known property of a number of other medications. 

Once this problem was noticed, all dermatologists for the next 40 years or so were trained to avoid long-term use of topical cortisone. Then, in 2004 an interesting experiment was conducted.  Micro-computer chips became available that could be embedded in the caps of medicine containers, and they could record the exact date and time each container was opened.  Patients with a common skin condition known as psoriasis were enrolled in this study, and were given topical medicine to put on their skin twice a day.   

Guess what the researchers found?  Over time, the medicine stopped working, just as before. However, the researchers discovered that most people (patients) started off using the medication faithfully. But then they slacked off.  Some even stopped opening their medicine containers entirely.  So it was not that the medicine itself mysteriously stopped working over time—rather, people stopped using it.  But their doctors didn’t have any way to “see” this, until micro-chips became available.  

NOTE: If you’re thinking why all those “stupid” doctors didn’t simply ask the patients if they were using their medication as prescribed…they probably did.  And most patients told them “sure, doc, I always do what you say,” especially back in the 1950s when things were much different between doctors and patients than they are now. 

So, this whole concept of tachyphylaxis, as a property of the medicine cortisone, was just a big misunderstanding.  And some of the best, brightest, and well-trained doctors in the world had been completely and utterly wrong about it for many, many years.  And all of this “wrongness” occurred (and got perpetuated) because of what doctors (in one compartment) couldn’t see about the behavior of their patients (who lived in another compartment) in their homes. 

How Does This Example Relate To YOU? 

Try to think beyond this example only pertaining to people with skin conditions being treated with cortisone.  Try to relate to the principle of arriving at false conclusions, about groups of other people, simply because you can’t “see” aspects about them that might change your mind, were you able to see them. 

Think about people’s motivations, for example.  Do you really know what’s truly in their hearts and their minds?  When you draw conclusions about why groups of other people, or even individuals such as one of your kids or your spouse, do the things they do, do you really have an accurate window into their hearts and minds?  At times, we all tend to think that we are a very good judge of what is probably motivating another person on group, but how often do you think we are correct?  More importantly, how often do you think we are wrong, much like the dermatologists in the example above, who turned out to be completely wrong, despite all their intelligence, caring, and training? 

Are Health Insurance Companies And Drug Companies Really Evil? 

Take a look at some of the emotional convictions and beliefs you’ve formed about health insurance companies and drug companies.  Were they based upon full and complete knowledge about what actually goes on inside each of these components of our health care industry?  Do you think you might have any “blind spots” about what actually goes on in those types of companies, or in the hearts and minds of the thousands and thousands of people who work for them? 

Do you really think all of those companies, and all of those people are evil?  Does that conclusion really make sense to you, when you stop to rationally (rather than emotionally) consider it?  Or may your opinion have resulted from the fact that you’ve only been allowed to see part of the picture—only the worst part at that—and you don’t really understand these “compartments” well at all. 

NOTE: Full disclosure—I work for a health insurance company.  Do you really think I am evil or uncaring?  Do you really think I stopped being a doctor at heart and stopped caring about the welfare of individual patients?  Do you really think health insurance companies as a whole are greedy, uncaring, and an impediment to people receiving top-quality health care in this country?  If you do, I can assure you there is much you do not know, and there is much you cannot see, from within your limited compartment.  And if you were able to see the whole picture, your opinions would most likely change. 

Sure there are well-publicized examples of uncaring greed, and indefensible behaviors, on the part of individual companies or workers in both of these rather large industries.  But these are very rare, and half of them are falsely portrayed by the media.  Either way, they don’t give you an accurate view of the truth about the value and integrity of these types of companies, and the many of your fellow citizens who work for them. 

Tip Of The Iceberg 

Maybe you don’t have strong negative opinions about health insurance companies or drug companies.  Maybe you never watch television news or somehow you missed the pubic, political debate over health care reform. 

I’ll still bet you have many other blind spots in your life that cause you to misinterpret or misunderstand the motives of other people.  One way you can tell if this is true for you is simply to ask yourself the following question: 

Do I have any stress in my life? 

If your answer is “yes,” then you absolutely do have blind spots.  They may be blind spots about other people, or about yourself, or about your career, or about how life works (either in general or specifically).  But have them…you do! 

The problem is…they are blind spots!   So you won’t easily see them. They don’t jump right out and smack you in the face, so you may not know they are there.   

Maybe someday, we’ll invent a computer chip or a wireless device that can tell us whenever our brain is missing something important.  Kind of like those back up video cameras that now come with some newer model cars. 

I wonder how much unnecessary stress and conflicts that little device could eliminate from our lives?  What do you think?   Please leave a comment below, if you like.





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