Health literacy should empower, enthuse medical well-being


Giving up has always been the quickest, unclean cut, way of dealing with challenges. When we just let go, step back and let the chips fall where they may, it almost always gives us an immediate result. Never a good answer, but a defined resolution nonetheless.

Please notice I said a resolution, not a solution. More times than not we still have the adversity, but with a lot more anguish due to the lack of our willingness to deal with it straight up. Sad to say that more than once in my life, I was guilty as charged, when it comes to this.

In 1965, Martin Seligman, a pioneer in the world of psychology, came up with a theory he dubbed “learned helplessness”. His study was to find out why we choose an uninformed, inactiveness in dealing with our problems.

Clinically, Seligman found that when an organism is introduced to an aversive event that appears to be out of the control, a quick cognitive path to helplessness over the situation is created in order to establish a pseudo-resolution. In English, when issues perceived as being too hard to deal with (i.e. debt, relationships, final exams, etc.); the instinctual response is to simply give up without exploring other options.

We’ve all done it to some degree or the other, but it’s important to understand how to battle back.

Today, Seligman would be challenged by animal rights activists, but some 50 years ago, he tested his theory by placing a shock collar on a dog, rang a bell and then delivered a slight electrical shock. He then placed the same dog in a subsequent experiment in which the canine was put into a large crate divided down the middle with a low fence.

The animal could both see through, and jump over, the fence. On the side where the dog was placed, Seligman installed an electrified floor that delivered the same light shock, only this time the shock was constant. The floor on the other side of the fence was untouched.

What is so fascinating is that Seligman found the dog chose to lie down and endure the pain of the electrified floor, rather than make the short jump over the fencing onto the safer side of the crate. The dog had been so conditioned to the painful situation that he would not even attempt to find an ulterior resolution. From this was birthed his theory.

Today’s need for health literacy

Here at Health Partners Free Clinic, a pharmacy student introduced me to Seligman’s theory during a journal review she gave while spending a month with us. The study analyzed health literacy and the ties to depression in an underserved population.

Health literacy is defined by The Patient Protection and Affordable Care Act of 2010 as ‘the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions’. I feel the study was a bit of a dud, but found the conclusions thought-provoking.

It showed that populations with lower levels of health literacy were found to have higher levels of depression. These same folks were also associated with lower perceived social supports, and higher levels of nicotine dependence.

In a free clinic setting, we encounter a segment of our citizenry that truly struggles with health literacy, and, I must say that hopelessness inevitably plays a role in their situation.

Make the illogical logical

Imagine when you wake up tomorrow everyone is speaking another language. Not unlike a bizarre form of communication you would hear in a sci-fi movie to ensure total confusion. Language immersion aside, you would feel pretty helpless that first day of your new normal.

This is exactly what an initial experience with the healthcare system can be like for those that are of low health literacy. Add to this the lack of a social support system at home for an individual to turn to for help and guidance. The situation contains the perfect makings for learned helplessness telling me Seligman’s theory is still spot on.

Could we step away from the focus on those with low health literacy and apply the lessons of this theory simply to a population that suffers with mild depression? To the dogs, after many exposures to the electricity, the animals just laid down and let their situation consume them rather than taking a new angle.

Does this sound like someone you know that suffers from mild depression? Does this sound like you?

As a natural introvert I know that if I spend too much time alone I can really start to get down, maybe even slightly ‘depressed’. Thankfully, I have a strong faith and social support system, and can quickly jump off of this “electrified floor” by simply interacting with other humans. Placing energy into someone else renews my own positive energy, and I highly doubt I am unique in this. This is my learned, ulterior resolution.

Help others in need

As a side note, this is also why I value volunteerism so much. Typically, I have found more personal healing power through the volunteer work itself, than what I deliver to those who benefit from my work. Just know that out there someone, somewhere, would gladly change their situation for yours in a heartbeat. There is always someone worse off than we are. Always.

I would challenge anyone who suffers with mild depression to spend time volunteering at a local non-profit as a part of their therapy. I know a couple of good organizations you can try.

So if we buy into Seligman’s theory, we might conclude that the cure for this learned helplessness is awareness. If his poor dog were aware that taking the small amount of energy to hop over the fence would lead to relief, then Fido would probably have leapt.

If people in our community were aware that a place like the local free clinic could compassionately provide them with the health care literacy they lack, then perhaps they would not hesitate to stop by and talk with our staff.

What fences in your life hold you or someone you love in learned helplessness? Could you be compassionate for someone who has been trapped in this state of mind after discovering this theory?

Seligman unlocked a concept using the same tool that may well have held him back from the discovery. That being his own mind.

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Justin Coby has been affiliated with Health Partners Free Clinic as a volunteer pharmacist since 2007, and was appointed executive director in 2012.

Justin Coby has been affiliated with Health Partners Free Clinic as a volunteer pharmacist since 2007, and was appointed executive director in 2012.

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