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“People Feel That Their Ability to Contribute to Society Has Been Terribly Thwarted” [issues.org]

 

By Anne Case and Sara Frueh, Photo: Unsplash, November 1, 2022

Anne Case, the Alexander Stewart 1886 Professor of Economics and Public Affairs Emeritus at Princeton University, has spent her career studying health across individuals’ lifespan and its relationship to socioeconomic status. Together with fellow economist Angus Deaton, she identified the pattern of “deaths of despair”—what they call the unexpected increase in mortality rates among working-class Americans in recent decades. Case and Deaton brought this problem to wide public attention with their 2020 book, Deaths of Despair and the Future of Capitalism.She is a member of the National Academy of Sciences and the National Academy of Medicine.

Issues editor Sara Frueh spoke with Case to get her insights into the economic and social forces driving deaths of despair, the ways that current policy initiatives might affect working-class Americans, and how the United States could start to stem the loss of jobs and generate meaningful paths forward for more of its workers.

You coined the term “deaths of despair.” What does that phrase mean?

Case: We use the words deaths of despair as a shorthand for death from drug overdose, alcoholic liver disease and cirrhosis, and suicide. All three of these causes of death speak of despair, and they are all, in a sense, death by one’s own hand.

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Why words matters note - the importance of distinguishing between "feels like" and "is/are".

It's a point I bring up frequently in trainings for counselors and social workers. While often not intended, there is a huge potential implied difference between the statements of....

"you felt disempowered"

and

"you were disempowered"

One statement is validating and factual. Is says "I see you and what you've been through, and there is no question". The other statement begs a question. It leaves ambiguous space for implying "maybe it's just your perception" and "maybe you're mistaken".

What's one of the primary forms of emotional abuse? Doubt and gaslighting. As such, I always caution service providers to be extremely careful and intentional about the use of "felt" versus "is".

Again, to be clear, in common everyday conversation we tend to use the terms interchangeably. Saying "I feel hungry" and "I am hungry" is synonymous. Saying "I felt disrespected" and "I was disrespected" is synonymous.

But for traumatized populations, it's often the case that ambiguous or otherwise harmless wording can be triggering and invalidating.

We need to be clear on statements of fact and not doubting. These people do not just feel disempowered. They are being disempowered. How we phrase things matter, and I would ask professionals like Dr. Case to strive to be more aware of wording and to utilize clearer, more affirming language in support of the population of trauma survivors.

Also, some notes of nuance that we're not perfect. And it almost surely wasn't Dr. Case who chose this particular quote to become the article headline. The point still stands.

The words we use matter, impact might not match intent, and we can hold representatives accountable for the wording they use, while also understanding that everyone is human and that language is an unruly, subjective thing.

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