Empathy only goes so far… then what?
Empathy from medical professionals has been shown to do a lot of things for patients -- increase satisfaction, improve clinical outcomes, lower risk of dying and even shorten common colds. And the empathy gap may be widest between highly trained professionals and low-income patients. Before you yawn and click something else, consider this:
Even with empathy, no one can help a low-income patient if they ignore how poverty changes the brain, which changes how help is received.
What’s helpful to a middle-class person may be useless to a person coping with poverty because his brain works differently.
How Poverty Changes the Brain
All human brains when overwhelmed narrow the focus down to immediate issues. Think of it as tunnel vision and the tunnel can fit only a few things. The day before an important work meeting, your brain is completely consumed by finishing your slides. You might take a break to go to your child’s sports game in the middle of this, but you are not really “there”.
A crowded brain neglects things, even if they are important. For a low-income person, it’s not a child’s game that gets missed – it’s the electric bill or picking up a prescription drug. Survival competes with survival for attention, and important things get crowded out.
A person living in poverty has a perpetually crowded brain, because fewer things are predictable. For example, income is not predictable for the majority of households in the bottom 20% ranked by income; their take-home pay varies by as much as 30% month to month.
A crowded brain will tend to value short-term over long-term benefits. In fact, the future may be entirely crowded out. Smoking is a prime example of short-term benefits – it may connect to a social ritual with a friend or relative, and after a stressful day, something calming is valuable. The far-off future prospect of lung cancer does not fit into the tunnel.
What Does Helpful Help Look Like?
To be truly helpful, help has to connect to something that already has space in the tunnel. For example, a person may be willing to cut down smoking around a child, whose coughing or asthma quickly get worse when the fumes rise. The child’s health is “in the tunnel” and relevant in a way that lung cancer is not.
Storytelling is a way to ease into a crowded brain. A story from a trusted peer about the food pantry would be more effective than a printed list of all the pantries. A list works for someone who can plan his time and who has mental energy for step-by-step thinking. This does not describe most low-income people.
Rethink the way you deliver help by looking at your service with “awkward eyes”. Try mentally or physically walking through your service from the client’s perspective and see what you take for granted. If you’d like help with this, contact us.
