Pro tips for 2018: Shift your scripts, and consider shutting up

I attended the August 2018 U. S. Breastfeeding Committee (USBC) meeting of its organizational members, and the subsequent National Breastfeeding Coalitions Convening [conference] (NBCC). The theme was “Advancing Public Health Through an Equity-Centered Breastfeeding Movement.” I’m for that! Excellent sessions, speakers, and award presentations, sharing advances (and challenges) in clinical and advocacy work in breast/chestfeeding and human milk use.

Dr. Jann Murray-Garcia gave two spectacular sessions on race/racism, bias, and the concept of “cultural humility,” a phrase coined by her and a colleague. Inherent biases — which every human being has — impact our interpersonal interactions in ways we don’t even realize or recognize. It is about automatic thinking (“Quick! What is 1 + 1?” We know the answer without even thinking about it). Dr. Murray-Garcia describes this phenomenon as a “script” (that “ensures the same and expected outcome”). But with awareness of this underlying driver of our behaviors, humans can also shift or re-write the script. Thoughtful thinking matters (“Quick! What is 11 x 17?” That requires some slowing down; a careful mathematical calculation). If you KNOW that your mind has been trained since birth (by family; by society and culture, by history) to have automatic assumptions and thoughts, you can start to disrupt and re-write those scripts by intentional, thoughtful interactions.

Juxtapose this scenario: A professional colleague of color described (yet again) a situation where whites were challenging the narrative of black persons who were describing their own black experience (about BFg and parenting). The commentary goes something like this: “You said X; couldn’t it really have been Y?” instead of “You said X. I believe X.”

It swings the spotlight from the speaker of color talking about their experience, around to some one who was not even there, and who thinks they have a better interpretation of what went on. Well, hmmm. This stuff has always struck me as rude and self-centered. And it is a function of privilege that whites do (a lot). And so I try to “check my privilege” and shut my mouth/open my ears as much as I can. I fail often, and I will say I have heightened awareness to just how frequently my clinical and professional discourses provide me opportunities to check privilege. This is a systemic and structural issue, folks.

And then I serendipitously stumbled upon the phrase to describe this: “epistemic testimonial injustice.”

I am something of a geek for anything Daniel Goldberg writes, especially on Twitter. He shared there a link to a heady legal-bioethics-disability rights conference where he presented, as a panelist. You’ll want to scroll down to the fourth video (in the link here) to view; his 15-minute section comes at about 41:00. While this scholarly context is about disability/public health, Goldberg talks about “epistemic injustice” which comes from the 2007 writings of Miranda Frick (“the epistemic side of oppression, focusing on racial and sexual oppression”) (here is a good review of that work).

“Epistemic injustice” recognizes it is possible to “wrong another in their capacity as a knower.” It is not about injustices connected to the traditional bioethical concepts of fair distribution of goods and services. It is about the “independent wrongness” of “silencing and invalidating and de-legitimizing when people share their own experiences.”

Testimonial injustice is when someone shares their own lived experience, and it is not believed; it is challenged, questioned, denied, de-legitimized. (Hermeneutical injustice is about “a shared lack of resources to interpret the experience of a particular group or a member of the group.”)

Whoa. I’ve got a whole new way to call folks in/out when I witness some spotlight-swinging.