Why do we learn so little from our psychological injuries?

When we experience physical injuries, we usually know quite well what to do. Some problems or injuries we can take care of ourselves. We use a band-aid when we cut our finger or we take an aspirin when we have an headache. And should a situation unexpectedly arise in which we are confronted with a more serious or consistent problem, we’ll seek help from a medical specialist. Nobody will think any less of us when we need medical help for a physical injury. 

Unfortunately, none of this applies to psychological injuries. While almost all of us, as children learned from our parents (or caregivers) how to take care of our bodies, most of us never learned how to take care of our minds. We are often unsure how to act when faced with everyday minor psychological injuries such as rejection, loneliness, failure, feelings of depression, stress, loss, or low self-esteem. A cough syrup, disinfectant or other practical aid from our physical first aid kit doesn’t help us with this, and our psychological first aid kit is often empty, or only partially filled. So what happens when we are faced with a serious psychological injury? Or if our everyday psychological injuries become chronic because we didn’t properly take care of them? Will we seek help from a mental professional? Unfortunately, although this is slowly starting to change, there is still often a stigma attached to psychological injuries and asking for psychological help. 

The ways in which we deal with our problems, but also the extent to which we actually learn something from our problems, is directly related to our perception and expectations. If we expect that we will be able to deal with our problems effectively, or if we expect that we will be able to find proper solutions for our problems, we’ll be more flexible in response to our problems and come up with and implement new strategies if our current strategies don’t work. While we’ll quickly lose our flexibility, and our ability to devise new strategies, if we perceive the failing of our current strategies as a confirmation of our own shortcomings. When we are confronted with an (everyday) psychological injury, our limited knowledge of psychological first aid results in the situation that we only have a very limited number of standard treatment strategies available to vary with. In addition, the stigma attached to psychological problems, and the shame that comes with it, can easily cause our self-worth to be further affected. This will not only make it more difficult to act flexibly in the event we are confronted with a psychological injury, but it will also make is more difficult to learn from our problems. 

Researchers have found that the functioning of our brain allows us to learn from the unexpected, from things that require more effort, and when we have confidence in our abilities. Under the umbrella term of “reward prediction error”, various researchers have shown that dopamine neurons, and the associated reward circuits in our brain, play an important role in learning. Our dopamine receptors are activated when the reward we receive differs from what we expect. When, so to speak, an “error” occurs in the expected reward. In the case of applying first aid for psychological injuries, this happens, for example, if the application of a new strategy (of which we don’t know in advance whether it will work) is effective. Our dopamine receptors aren’t activated when the reward matches with what we expect. So if we apply an existing strategy from our psychological first aid kit that we expect to be effective in advance (because it is a proven strategy that we have successfully used before in similar situations), our dopamine receptors don’t respond when the application of the strategy meets the expectations. Our brain is doing something clever here. Because our dopamine receptors respond to the unexpected, in this case our dopamine receptors are not activated in response to the reward itself, but instead when we perceive a stimulus (we don’t have influence on this ourselves so this is unexpected) that produces a predictive value that this strategy will be successful. Our brain forms a pattern to ensure that when a stimulus occurs that is predictive of a reward, it creates an appropriate motivation for us to implement a known successful strategy. Obviously, an unexpected reward, or an “error” in the expected reward if you want, can consequently result in an adjustment of the pattern if the strategy no longer works.

Psychologists have long known that we value a reward more when we have worked harder for it. However, until recently it was unclear whether and how our efforts affect the way our brain processes reward information. To investigate whether the activation of dopamine receptors in case of a “reward prediction error” is related to the amount of effort it takes to apply a strategy, researchers at Tamagawa University placed electrodes in the brains of Japanese monkeys. The researchers had the monkeys perform a task under two conditions, one in which it took the monkeys little effort to complete the task and one in which the monkeys had to put in a lot of effort to perform the task. The researchers found that if the monkeys had performed a task under the high effort condition, the dopamine receptors showed increased reactivity during both the observation of a reward predicting stimulus and in response to the reward itself. In addition, it was found that the monkeys learned faster when the task required more effort. 

When we are confronted with a physical injury, we have a properly stocked first aid kit on hand. There are several stimuli that can motivate us to apply a known strategy. We clean an injury to the skin thoroughly, we can soften a tickle in the throat with some honey, we cool a sprained ankle, etc. And if a standard strategy results in an unexpected outcome (it doesn’t work), we react flexible and try an alternative strategy. 

This can play out very differently if our firs aid kit is empty of less well stocked. As, for many people, is the case when it comes to psychological injuries. If we are faced with a psychological injury, and we expect that we are unable to come up with a good solution or we experience the injury as a personal shortcoming, we’ll quickly lose our flexibility and find it very difficult to come up with alternative strategies. Our efforts to look for new strategies decline rapidly. There are hardly any existing strategies available for us to apply, so every stimulus results in almost the same approach. And since we already expect our strategy to yield little, the outcome is no surprise. Our dopamine receptors are not activated because the outcome is exactly what we expect and our effort is minimal. As a result, we learn little or nothing from our psychological injuries. It is for good reason that most people, when their standard strategy for treating psychological injuries doesn’t work, for lack of flexibility only try to apply the same strategy better. 

Imagine that at the end of each working day, you routinely have piles of work and unanswered emails left. This is starting to take its toll. You experience a lot of stress, you sleep badly because you start worrying at night, and you are snippy to the people around you. How do you deal with this? If you experience the problem as a confirmation of your personal inadequacies, chances are that you will come to the conclusion that you just have to work a little harder. Maybe you decide to work an extra hour every night after dinner to answer your unanswered emails, or maybe you decide to start an hour earlier every money so you can get some work done before your colleagues come in for work. Another option is that you perceive yourself as being good at your job. And you expect that you will be able to come up with a good solutions. You come to conclusion that the way you have been doing things so far, don’t work very well any more. Perhaps you decide from now on to only handle matters via email that can’t be handled personally. And you start a conversation with your colleagues to discuss what these changes mean for your cooperation with them. 

Psychological injuries are just as common as physical injuries. Unfortunately, our existing unfamiliarity with the topic makes it unloved. We don’t invest in the treatment of psychological injuries and therefore we learn less from our experiences. It’s about time that we start to change this. Fortunately, we now know that we learn faster if we invest more effort.

Just as most of us have to catch up when it comes to dealing with psychological injuries, our organizations (companies, governments, etc.) have to catch up when it comes to dealing with complex problems. For example, our prime minister told us during his last press conference regarding new Covid-19 measures, that we need a bigger hammer. This raises questions about the contents of the first aid kit that we have available for complex problems. Is this kit filled with hammers only? More on this in the next blog.