by Stephanie MoDavis
We are rapidly becoming aware that healthcare cannot ignore the complex interplay of cognitive, emotional and social factors that contributes to wildly divergent mindsets among disadvantaged patient populations – ranging from determined self-advocacy to resigned helplessness. Understanding these psychological drivers and spectrum of “patient” is crucial for creating personalized systems of support tailored to overcoming unique barriers.
Internalized beliefs and messaging shape response patterns when faced with structural marginalization. Psychologist Martin Seligman’s theory of “learned helplessness” shows how trauma conditions powerlessness such that victims automatically expect failures they cannot control or influence. Over time, this eroded self-efficacy breeds passivity and withdrawal even from accessing available resources. (Sadly, this behavior also exists amongst those who claim to be experts in field).
Conversely at the opposite end of the spectrum, an empowered stance refuses victim identity. Again if we embrace nuance, this can look like a healthy or integrated state of reality or it can be “used” as a bypass as one cultivates a facade while suffering in silence. This lack of balance or limited prognoses by leveraging individual talents and collective supports, hinders a greater opportunity for wholeness beyond the physical. Bolstered self-worth sustains continuous growth in skills, knowledge and community belonging – amplifying capacity rather than constraining possibility despite hardship, as long as we are being deeply honest about our feelings and aren’t hiding for appearances. As Jim Carry states, depression is the avatar being tired of playing a character we truly are not. Not a scientist or Doctor, but somehow that delivers a blatant gut punch that at certain times in our lives so many of us can relate with.
Unfortunately, healthcare culture frequently paints patient engagement through high-visibility advocacy as the epitome of empowerment. But this glorification of shining a spotlight on one's journey risks dangerously misreading many people's psychological capacity so soon after life-altering diagnosis. Not everyone has adequate support or resilience to manage the demands of becoming a community leader in their darkest moments of needing to quietly heal. It is an alluring distraction. What's first required for many is the freedom to retreat, process complex emotions, and integrate this disruption into one's spirit without judgement or timelines. Space, authentic grieving, and self-work carves room for post-traumatic growth to organically arise when the time is right. Forcing affected voices to conform to formulas of inspiration porn mandated by others' expectations for PR purposes can profoundly impede inner transformation. The most empowering systems provide multidimensional outlets for taking back control on one's own terms and timeline.
“All of us are born with many sub-minds―or parts,” says Dr. Schwartz. “These parts are not imaginary or symbolic. They are individuals who exist as an internal family within us―and the key to health and happiness is to honor, understand, and love every part.”
Self-determination theory explains motivations behind each mindset orientation. Those focused on plugging holes in deficiency needs get stuck battling disadvantage. But opportunity-seekers embracing the growth drive towards self-actualization progress ever forward – seeing hardship itself as an education advancing their goals. And within this framework lies a spectrum and an inverse spectrum or what we may label the hidden, occulted, or shadowed. Those parts of us that require us to face ourselves and our own agendas in a way that challenges the very nature of who we are and our identity we display. Disrupting these “optics” is something that only the very brave have been willing to face.
Of course, even grit requires fuel. Healing past wounds around safety, love or esteem establishes firmer footing to extend helping hands to others. Research shows interventions like psychotherapy, peer support groups and nature immersion renew psychological bandwidth after coping depletion. And the individuals who have been willing to dive into the fire of transformation are the very individuals to help others who desire their illnesses to be a form of possibility and life purpose rather than something to overcome or sadly die from. What I am saying is one can self realize, with illness, even when recovery is no longer physically possible.
We have two lives; the second begins when we realize we only have one -Confucius
Western healthcare prides themselves on technological advances and evidence based outcomes directing focus primarily on physical measures to determine "health". Ask millions whom identiy as a patient and they will tell a differernt story. That health is just as much inner as outer. If we care the way we claim to, we're going to have to level up. And that means all of us, even the most recognized patient advocate to decorated PhD.
If the healthcare system woke up to the real determining factors in patient outcomes while having the bravery to face why they don't, we could cut through surface-level labels to nurture the fuller human behind them. Providers would shift from shaming and blaming or the extreme of coddling or avoiding and embrace and uplift intrinsic aspirations and strengths no statistic can quantify. We possess far more resources than we know – with help of those who are brave within the field. This is a collective effort based off equals with a shared vision and range of expertise and experience. When we surrender together only then can we excavate our untapped potential for our western healthcare "system". After all the system is us, what we tolerate, what we adcocate for, what we ignore, and what we fight for.