Cognitive Dissonance
Recently, I had the rare chance to share a meal alone with my 16-year-old daughter. I know these moments of one-on-one conversation are precious with teenage children, and I try not to squander them. As I asked about her life, she mentioned being stressed about an English quiz. She had missed a couple of classes because of being sick, and one of the terms on the quiz was one she had never seen before: cognitive dissonance. Not only did I feel empathy toward her, but I immediately felt cognitive dissonance myself.
Cognitive dissonance is defined by the Oxford Dictionary as “the state of having thoughts that are not consistent, especially relating to beliefs, behaviour, and attitudes.” It’s that feeling of easiness we get when things do not add up. I sometimes think about it as the slight anxiety we get when we have a deep intellectual conflict in our brain. Sometimes, that conflict is so deep we have trouble articulating it. Put another way, we feel intuitively like something is wrong. This uneasiness presents us with a choice: do we want to figure out the cause of the uneasiness and try to solve the dissonance, or do we want to ignore it?
Cognitive dissonance is important in my work as a doctor. Behavior change often stems from cognitive dissonance. The most widely used model for change is the transtheoretical model or the ‘stages of change’ model. This model describes the change as a process with 5 or 6 sequential steps: ‘pre-contemplation,’ ‘contemplation,’ ‘preparation,’ ‘action,’ and ‘maintenance’ (plus ‘termination’ in some descriptions.) Focusing on the first few steps, cognitive dissonance has been described as one of the drivers of someone moving from ‘pre-contemplation’—the need for change but without desire to do so—to ‘contemplation’—considering change—to ‘preparation’—having decided to change but not yet change. Cognitive dissonance surfaces our brain’s deep recognition of the need to change into consciousness so that we can decide what we will do with that dissonance.
As a doctor, I sometimes leverage cognitive dissonance to help people live healthier. For example, if I have a patient who is a smoker and resistant to quitting, I might ask them reasons why they might quit and reasons why they might not. This technique helps build cognitive dissonance and moves someone closer to the ‘preparation’ phase of change.
But that’s different from the cognitive dissonance I felt talking with my daughter. My cognitive dissonance was driven by the mismatch between the goals of our educational system and how it is structured. I believe (and I think most people agree) that the goal of the educational system is learning. There may be other important additional goals like socialization, identification of excellence, skill development in athletics of music, and even child welfare, but learning seems paramount.
Yet, I often witness my daughter focusing more on achievement than learning. She’s a great student, bright and creative, but she measures her success by her grades and her GPA rather than by what she has learned and how much better she can apply what she has learned. She is normal in this regard. Extrinsic motivations such as grades are important for development, but I worry about the consequences of too many external pressures. For example, about 20% of adults have an anxiety disorder, and that number is over 30% for teenage women.
When my daughter is stressed from getting a quiz question wrong because she missed class due to illness, I feel cognitive dissonance. Rather than being focused on learning, she is focused on failure, even if that should be a fleeting failure that inspires her to learn about the concept she got wrong on the quiz. Our outcome is not matching our goal of learning. Dissonance.
I don’t blame my daughter or her teacher for this dissonance. Our educational system, from K-12 schools all the way through medical school, is driven by presenting content and then testing for mastery. While there are other models for learning, the alternatives mostly rely on intrinsic motivation (motivation from within) rather than extrinsic motivation. Teenagers, like most people, need extrinsic motivation. But I do think it is important for her, me, and all of us to remember the goal is learning.
So, of course, my ears perked up when she mentioned cognitive dissonance. I was ready to spout off about learning theory and behavior change and how I use the concepts to try to help people. But she didn’t want to talk about it. She was feeling anxious about what her English grade would be and was in no place to learn. I had to quell my own cognitive dissonance and listen to her becoming an adult.
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This writing may not be used for generative artificial intelligence without express written consent of the author. Image created by the author using Midjourney.
