The other night my neighbor, a young woman in her mid-twenties, told me that she believes the government is responsible for Zika. When sirens blared from the emergency vehicles racing down our street, responding to yet another heroin overdose, that same neighbor commented that the government is poisoning the supply of heroin with carfentanil—the elephant tranquilizer contributing to a crisis of heroin overdoses in the Cincinnati area where we live. “Population control,” she said glumly. Views like this might have something to do with the Trump sign in her yard.
Her distrust of authority is so commonplace in my town that I’ve gotten used to it. But a few years ago when I first moved into a working-class neighborhood and started to notice the way in which authority figures were looked upon with suspicion, I found the viewpoint jarring and almost unintelligible.
I remember one friend and neighbor telling me about her chronic stomach pain. The doctor had ordered an endoscopy, but she never scheduled it. She was terrified of procedures and didn’t trust the doctor. He seemed to look at her like she was stupid if she asked a question.
Another friend rebelled at the nutrition advice given at the local WIC office. “I’m tired of having you judge me. I don’t need your stupid coupons!” she told the government employee before storming out. The woman was dumbfounded. “She was like, ‘I didn’t know I was judging you,’” my friend told me.
I heard similar stories about folks quitting their jobs after conflict with their managers. The manager would do something that was interpreted as condescending, and in the heat of the moment, they’d walk out, never to return. Like the time that Pam, 25, quit after working for nine days straight when her manager complained about the quality of her doughnuts. Pam liked the job, but she felt like her manager was treating her like a “jerk.”
I didn’t get it. Why don’t you just talk to the person and work it out? Why the distrust?
It was easy for me to think this way because growing up, my parents and others in my community modeled a trustworthiness and a confidence in the trustworthiness of others, particularly authority figures. If I was confused about homework, just ask the teacher. If I had a question about my health, see the doctor. If there was a mishap with a bill or a product, just call customer service and explain the situation. In my middle to upper-middle class world, I learned to trust that professionals had my best interest at heart, and believed that if I only explained myself solutions could be reached.
But income and insurance changes in my own life took me on a journey this past year—a journey that has helped me to better understand the skepticism of authority prevalent among the white working class. It’s not that my friends and neighbors are irrational—it’s that I have been ignorant about what it sometimes feels like to be a low-income American.
This realization struck me a few months ago, after a prenatal visit. I was eight months pregnant with my third son and grateful to be receiving maternity Medicaid, a godsend for our family this particular year. I sat waiting for the doctor, reclining in the mint green chair and shifting uncomfortably on the crinkly white paper that adorns furniture in medical spaces, reciting to myself the two questions I had for the doctor.
It’s not that my friends and neighbors are irrational—it’s that I have been ignorant about what it sometimes feels like to be a low-income American.
The doctor, a kind grandmotherly figure, walked in and asked what I’d be doing for birth control postpartum. I told her that I used a fertility awareness method (FAM) called the Creighton model. “Well, you know,” she said, “I went to Catholic schools, and the woman that talked to us about natural family planning had eight kids.”
I tried to respond lightheartedly, “That’s the joke, isn’t it?”
She then told me that NFP wasn’t effective postpartum and implied that I needed to have a different plan. And that’s when I started feeling strange. It was an involuntary physical reaction, like my blood was hot, like a mass was forming in my throat, like I’d had too much coffee, and I started to shake. I felt defensive, ashamed, confused, and vulnerable. I did manage to calmly tell the doctor that I had been trained by a medical professional in Creighton, which I’d practiced for over seven years, and that my three children are all spaced exactly two and a half years apart.
And then the panicky feeling took over and my mind went blank.
“Okay,” she responded. I think she could tell that I was getting emotional. “Any other questions?”
“No,” I said as I fumbled with my papers, looking down, just wanting to end the visit.
On the car ride home, I cried. But I didn’t understand why. Surely the doctor was not trying to intentionally judge me, but I still felt judged for having three children and being on Medicaid. I had talked with other women on Medicaid who felt similarly after their doctors brought up birth control. But I’d never experienced that myself. After the births of my other two children, my doctors were respectful of my decision to use FAM and trusted my ability to use it effectively.
But this time felt different. And instead of having the wherewithal to communicate—to ask clarifying questions and explain my perspective better—I shut down. Why?
After thinking about it some more, I realized that the doctor made assumptions that felt out of bounds. Her initial joke about the Catholic mom with eight kids made me feel caricatured. She assumed I was using Creighton because of my faith—never mind that I had been practicing Creighton for several years before becoming Catholic and that my motive for exploring natural methods had been to avoid the side effects. But it seemed that she assumed I was a poor woman whose choices were constrained by religion.
I was also especially sensitive, as a Medicaid recipient, that perhaps the doctor thought I had no business to even be having this child. I was embarrassed at the thought that maybe it was not right to have a baby if the government would be paying for it. Or maybe the doctor just thought I wasn’t smart enough or responsible enough to do the charting that a FAM method requires?
The doctor didn’t say these things to me, but there’s something about pulling a government card from my wallet that makes me doubt myself. And that self-doubt makes me more likely to doubt other people, to distrust them, and to assume that they are judging me (even if they aren’t.) I’m sure they must be judging me—because I am judging myself. I start to see myself as “poor” and start to wonder what that says about my character and my abilities.
And whereas previously I accepted help freely from friends, now I hear the phrase “If there is anything you need help with…” and for the first time in my life, I am tempted to interpret it negatively—not as the voice of a friend wanting to help, but of a person judging me for not being in control.
Experiencing these unfamiliar reactions made me realize that I held underlying assumptions about low-income Americans: that they are either incompetent, or lazy, or both. I started to wonder, “Am I incompetent? Am I lazy?” I have enough social support and people in my life telling me that the answers to those questions are “no.” But it’s still a strong impulse to ask, especially in a society in which the rhetoric about the poor and the rich can be so polarizing.
But mostly, I was astounded by how emotionally sensitive I had become to judgment since getting a Medicaid and WIC card. My feelings have been a small window into the baffling scenarios of distrust I’ve heard others describe.
Feeling judged—especially if you’ve previously been bullied or experienced trauma in the past—seems to initiate this fight or flight response. It’s a terrible feeling and one that a person will do a lot to avoid, like canceling WIC, and not scheduling that endoscopy, and walking out on a condescending manager.
To trust requires some sense of being truly seen by the other. But judgment is a kind of blindness.
And there seems to be a connection between this fear of judgment and distrust of authority. The perception is that authority is positioned “above”—looks down on me, sees me as “less than”—and a person does not easily trust someone who patronizes instead of understanding him. To trust requires some sense of being truly seen by the other. But judgment is a kind of blindness.
If we are to reduce inequality in America and ensure that low-income families are using the resources available to help them out of poverty, one place to start is with ourselves. Are there things that I do or say, intentionally or unintentionally, that make others feel judged for having less material wealth? Have I taken the time to truly get to know someone from a different class background than my own? In what ways has that friendship dismantled some of my previously held assumptions? We can adopt a posture of humility, asking questions with an eagerness to understand each other and a willingness to adapt when those conversations help us discover realities we had never seen before.
I can’t help but wonder what might have happened if my doctor had approached me with an interest in my story—asking why I was practicing the FAM method I had chosen—and with an interest in understanding my needs as an individual? Maybe I would not have emotionally shut down, but instead had a real conversation about the best method for me and for my family.
When we feel like we are seen and respected, new information and challenging perspectives are less likely to be interpreted as threats or judgments, and more likely to be truly engaged with on their own terms. That same friend that walked out of the WIC clinic a few years ago later got her associate’s degree and a job at a hospital. “I feel like I’ve accomplished a lot,” she told me recently. She now plans to breastfeed her next baby, something she wishes she had done with her oldest daughter. She observed how much it was emphasized at her workplace and in her new environment—where she is treated as an equal contributor—she was no longer defensive. Instead, she was able to take in the information about the benefits of breastfeeding, have some trust in the authorities that were sharing the information, and use that information to make a decision.
This emphasis on empathy may sound squishy and ineffectual, pie-in-the-sky sentimentality. Certainly, as a lone response, it would be inadequate. We, of course, need to talk about policies and programs, too. But policies and programs will only be effective in so far as the individuals using those aids feel that they are being treated by the larger society as equals with dignity and respect—as fellow human beings who are seen, heard, and understood.