“Cognitive bandwidth” is a term you may not have heard but a concept that makes sense from the minute you encounter it.
We all know that referring a seriously depressed patient for “talking” therapy is probably not going to be very useful. In severe depression, and severe anxiety for that matter, concentration and focus are sufficiently impaired that any attempt to try to think differently, (as cognitive behavioural therapy requires) is fairly futile.
A recent article from Pacific Standard magazine about behavioural economics (of all things) dropped the notion of “reduced cognitive bandwidth” into my universe and it chimed loudly, as ideas do when they make immediate sense.
The article focuses on the effect of poverty on our ability to think clearly and rationally. It also mentions a lot of other very important things that, when they are scarce, can reduce our ability to think flexibly and creatively and impair our problem solving skills - in other words, that can narrow our cognitive bandwidth. Interestingly these things include time, food and sleep.
In 2013 two academics, one a behavioural psychologist and the other an economist, published a book called “Scarcity: Why having too little means so much”. One of the book’s authors, Eldar Shafir, (the psychologist) gives a TED talk about the research that supports the idea that in conditions of scarcity of either of money or time, cognitive bandwidth and problem solving skills decline. Scarcity creates a similar psychology for everyone, a psychology that contributes to positive reinforcement cycles where things get worse rather than better.
How does knowing all this help us help our patients with common mental health conditions?
Perhaps it helps us to understand what drives our patients to make the decisions they do and why the very rational solutions we present them with do not seem to be possible for them.
Perhaps it can help us help them negotiate their difficulties better by focusing on simple manageable changes that will help them turn things around, rather than expecting too much of them all at once.
Perhaps too, it will make us recognise how the pressures we experience in our own lives may impair our thinking. Maybe we too need to take more urgent action than we think to improve the balance of our lives and address our own “scarcities”.