Preexisting Biases Affect Our Perception

“We Don’t See Things As They Are, We See Them As We Are.” -Anaïs Nin

Dr. Feldman

Last month, I wrote about binge watching the Stranger Things series and about its clear focus on how we hurt ourselves when we hurt others.1 At least that is my perception of the series. Others might have thought it was about adolescence and dating, making and breaking promises, honesty and lies, the risk of government experiments, abuse of power, or, perhaps, just entertainment. What we perceive is highly dependent on our preexisting biases.

How we perceive things is a very strange thing, as evidenced by how strikingly differently people perceive the current (or any other) president and his (or, perhaps someday, her) actions. It did not surprise me that I found the current season of Stranger Things to be about conflict and the way we hurt ourselves when we hurt others; I see similar issues everywhere I look because I am looking for it. It would not surprise me if many readers disagreed with things in my previous columns, as readers perceptions may be very different from mine on some issues, depending on their background. For example, I passed the dermatology boards when there was lifetime certification; therefore, my perception of the requirement for more recently boarded dermatologists to complete maintenance of certification requirements may be very different from the perception of more recent, time-limited certified graduates. Being able to recognize our own biases and to understand how they affect our perceptions would be extremely valuable but is perhaps a rare skill.

When it comes to moral judgments, our emotions determine what we perceive, then our cortical reasoning does its very best to justify what we have already decided. Jonathan Haidt describes our judgments as being formed by an emotional elephant, driven by a rational rider; if the elephant wants to go in a particular direction, there is not a lot the rider can do to change it.2  Trying to reason with someone who has a different perception from us, perhaps a patient (or a lover or an enemy) for example, over any conflict is usually bound to fail. As each party comes to those efforts with a different emotional outlook, reason is a weak tool for bringing about convergence or agreement. For practical purposes, at least with patients, it often may be better just to agree (even though we don’t) and move forward. 

Steven R. Feldman, MD, PhD

Chief Medical Editor

Dr Feldman is with the Center for Dermatology Research and the Departments of Dermatology, Pathology, and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC.


1. Feldman SR. Turn the other cheek. The Dermatologist. 2018;26(8):8.

2. Haidt J. The Righteous Mind: Why Good People Are Divided by Politics and Religion. New York, NY: Pantheon; 2012.