Learned Helplessness is a psychological term that means you stop trying, when things feel impossible or out of reach. When your environment or life sends you messages that you cannot do something you begin to automatically assume that you shouldn’t even try because the task is impossible. Overtime a habit of helplessness develops. This happens all the time mostly on a subconscious level. This happens between husbands and wives, siblings and friends. “My husband will fix that he is better at that than me.” “Susie is the planner of the group. I will make a mess of it.” “My big sister is good at math. Let her figure out the tip.”

Math is actually a great example. If you had one bad math teacher, and consequent bad math grades you determine that you are “bad at math.” Then as an adult when the bill gets passed around your hands get sweaty and you quickly swipe for the tip calculator under the table. The thing is it is a self fulfilling prophecy. You think you are bad at math. You do not attempt to do math. Your left brain muscles get weakened. It becomes harder. You think you are bad at math. Does any of this sound eerily familiar?

Like you know this feeling, but just cannot put your finger on it? Look no further than your hemiplegic hand/foot, poor balance, impaired vision/memory, or aphasia. Yeah. Learned non use is the same thing as learned helplessness and it is poison for the recovery process. For years and years, we taught people to compensate. We taught people to get adaptive equipment, which I still love, and deal with their deficits.

It is different now. Times are changing! Yes adaptive equipment to help you regain independence, but not to use and continue to neglect your affected side. You quite literally NEED the struggle. It is the only way to forge new pathways. Forge is a good word, it doesn’t sound fun does it. Well, it isn’t always fun, but it is always good. We need to challenge our brains and do it a lot.

The cheesy saying “You have to believe to achieve” is actually a very sound statement. If you are deeply entrenched in the belief and thought that you are powerless against your brain. You will not see opportunities where you can slowly engage your eyes or open your hand. The cycle of helplessness has to be broken and you are the only one who can really do it. Learned non use has been heavily researched in animal and human models. Repeated exposure to environments where one feels disempowered will result in disempowerment. The thing that gets me is, with brain recovery, just as you begin to get faculties back patients are becoming more and more convinced that they should not try. It is like climbing up a mountain during a mudslide and I am at the bottom yelling at my patient to keep going, but all they can see is mud and more rain. From this vantage point, they cannot see the clouds parting and the sun coming out. I can and have seen it. I know from experience, the person who can keep their head up makes it to the top of their mountain.

One of the hardest parts of this journey is learned non use of your affected limb. Many therapists do not address this phenomenon and focus on allowing the other hand or foot to take over dominance, but 90% of the time I think that this is at the very least an unhelpful approach. I always try to engage the more affected limb, because we know from hard evidence that motor control can be regained and learned non use can be overcome. Constraint induced movement therapy was born out of research on learned non use.

I love CIMT, in fact, its on my to do list to get certified in it. The idea is that you constrain the less affected arm to allow the more affected arm to work. This has incredible results. If I don’t have a glove on my clients I am basically a verbal constraint as I am constantly asking “why didn’t you use that hand?” or snippily gesturing toward their affected hand with a dramatic sigh. Especially, if it is their dominant hand. I show no mercy.

My favorite thing is when a client says that they can put their shoes on and tie their laces. I know that they are doing this completely with the use of their less affected hand, so I will ask them to do it for me. My twisted heart is getting more and more excited with each flick of the WRONG hand, because I am about to blow their mind with enlightenment in three, two, one. I crouch in front of my victim (ahem) client and in an even voice ask “why are you missing this opportunity every day to work on your hand?” Truth bomb levied silence ensues. 99.9% of the time they look at me incredulously, because “I can’t”. There it is the piece de resistance. This is the crux of the problem. This is the cycle of violent helplessness that feeds our non use. My response after several seconds so they can hear the weight of their words. “Of course you cant. You haven’t even tried.”

Learned Helplessness and Learned Non Use Go Hand In Hand