“Tell me, what is it you plan to do with your one wild and precious life?”
Mary Oliver, Pulitzer Prize winning poet
More and more we have fast and vehement answers for everyone on everything. From diet and exercise to parenting and economics, we are a culture with strong and loud opinions on all the topics. We often forget to ask why, because we already have so much information at our fingertips accompanied by prepackaged summary opinions.
Our educational system doesn’t usually promote curiosity either. We are taught to achieve on a series of standardized tests with “right and wrong” answers, reduced to the tiny bubbles of a scantron form. “You got 47 out of 54 questions right.” It’s either right or wrong — black or white. Even the essays are now scored in a way that leaves little room for creativity or exploration.
Curiosity is introduced at times in elementary school science, if done well, but then lost in middle school through a series of educational benchmarks and milestones that never measure or value it again. Subtlety and depth are not exactly in fashion right now.
Our media and news sources don’t promote curiosity, or its cousin, empathy, and are polarized as are our politicians, with no room for gray, which is usually the color of most complex issues. Whether addressing societal unrest around racism or struggling through depression or diabetes, we could all learn to do more asking “why?” than we are accustomed.
I recently read a quote from author Glennon Doyle Melton that spoke to this well. “Let us be curious instead of defensive. When someone says ‘I’m hurting’, let’s say ‘Tell me more’ instead of ‘No you’re not’.
Curiosity is key to understanding complex situations. If you come in with all the answers, whether as a physician, parent, teacher or priest, you won’t really understand the other person’s perspective or realities of their struggle, which is as real as they perceive it is. Asking open-ended questions (“Tell me more about that” and “Why?” are good ones) and then creating space to really listen, is the first step to empathy, another crucial skill not often honed in schools or even places of worship where one would think it should proliferate.
Curiosity and empathy are linked to successful intervention and outcomes in people with addictions and many other health problems that require an individual or family to make changes in their lifestyle. When you think about a positive change you or others have made, at some point the question “why” was asked and answered. Why do I smoke? Why don’t I sleep enough? Why do I need the alcohol? Why do I eat so much? Information and facts (“You should eat 5 servings of fruits and vegetables a day”) are important but usually not enough to make the change successfully.
We need to understand “What motivates us? What are the barriers? Why do we or don’t we make healthy choices, and how do we feel as a result?”
It may sound “touchy-feely” to some, but the science is there. The use of a counseling technique call Motivational Interviewing (MI), which incorporates empathy and curiosity, has been shown to be effective. “Motivational Interviewing is a clinical approach that helps people with mental health, substance abuse use disorders and other chronic conditions such as diabetes, cardiovascular (disease) and asthma, make positive behavioral changes to support better health.
The approach upholds four principles — expressing empathy and avoiding arguing, developing discrepancy, rolling with resistance and supporting self-efficacy (a person’s belief s/he can successfully make a change),” according to the Substance Abuse and Mental Health Service Administration-Health Resources Service Administration SAMSA-HRSA website www.integration.samhsa.gov.
Jennifer Mota is a Community Health Worker with the Salud y Vida program through the University of Texas, School of Public Health (Brownsville Campus). She is trained in Motivational Interviewing techniques. She works with folks who are struggling to control their diabetes and face many barriers including financial, mental health, family violence and no health insurance. She connects them to resources like clinics, medication and transportation, but also meets with them regularly right in their homes in order to motivate them to make healthy changes to their diet and physical activity to better control their diabetes.
“When I meet with people my first job is to listen. I am really curious as to what are their struggles and barriers, what are they interested in changing, what have been their experiences and what are their expectations and goals? I use MI to help them discover their own ambivalence about making changes and express in their own words their desire for change. I really try to empathize, listen and discover with them. It’s amazing how much more effective this is than just giving people information about what they “should” be doing, which is what our healthcare system usually does.”
Mota’s work, along with her colleagues, has shown positive results. The majority of the participants in this program (over 4,000 across the Valley enrolled) are improving the control of their diabetes, as evidenced by lowering their HBa1c results. The HBa1c, or the Hemoglobin A1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months.
Curiosity, listening, open-ended questions and empathy are all crucial for individual change and societal change, because Tu Salud ¡Si Cuenta! (Your Health Matters!).