I'm in a seminar that meets once a week to educate ourselves in the technique of CBT (cognitive-behavioral therapy). This is one of several available therapeutic modalities (dialectical behavioral therapy, psychodynamic, psychoanalytic, etc etc etc).
We're learning specific, codified techniques for making our interactions with patients productive. Some of them are very simple; but the results are absolutely amazing. What's been most useful for me has been a technique designed for talking down an angry, irrational patient.
We're learning specific, codified techniques for making our interactions with patients productive. Some of them are very simple; but the results are absolutely amazing. What's been most useful for me has been a technique designed for talking down an angry, irrational patient.
When I was a medical student, one of the things that attracted me about psychiatry was how smooth the attendings were about dealing with difficult patients. You'd have an obnoxious patient on the medicine or surgery floors who would have all the docs chewing their stethoscopes with utter frustration. Then the psychiatry consult would walk in and in three minutes he'd have the patient eating out of his hand. Unbelievable. I wondered whether this was a talent they were born with or a result of their education. (Ultimately, as with most things, it's probably a little bit of both.)
It's a bit of a chess game, as one has to think a few moves ahead. If I say this, he'll likely say this. If I don't say this, another chance may not come. If I say it in this particular way, will he react well or badly?
It's perhaps funny to imagine that human interactions could be condensed down into a set of algorithms. One would like to think that individuals are so very different from each other that one size could never fit all. And it's true that one needs to apply one's interpersonal intuition to an extent. But only to an extent. There are specific, effective methods to bring angry or frustrated patients back to a state in which they can engage in rational conversation.
And their use isn't restricted merely to the controlled environment of a hospital or clinic. I've used some of the basic techniques we're learning with other angry, irrational people in my life (mainly frustrated residents from other services) with excellent results. Secret weapons!
It's a bit of a chess game, as one has to think a few moves ahead. If I say this, he'll likely say this. If I don't say this, another chance may not come. If I say it in this particular way, will he react well or badly?
It's perhaps funny to imagine that human interactions could be condensed down into a set of algorithms. One would like to think that individuals are so very different from each other that one size could never fit all. And it's true that one needs to apply one's interpersonal intuition to an extent. But only to an extent. There are specific, effective methods to bring angry or frustrated patients back to a state in which they can engage in rational conversation.
And their use isn't restricted merely to the controlled environment of a hospital or clinic. I've used some of the basic techniques we're learning with other angry, irrational people in my life (mainly frustrated residents from other services) with excellent results. Secret weapons!
Next entry: Getting people to be rational is both easier and harder than it seems.
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I'm going to post a follow-up to this that will go into a little more detail though, probably enough to let you give it a shot in real life. It's really not that complicated.