24 May 2017

Helping patients with self-destructive negativity

Clinical Psychology

Sometimes I have days in the surgery when my psychology skills are more in demand than my medical skills.

Perhaps that’s the trick of general practice, getting into that patient’s head to understand what’s really worrying them, and doing this comprehensively every 15 minutes.

Often it’s straightforward. Ask a few open-ended questions. Give them time to answer. Acknowledge their concerns and address them. But sometimes – just sometimes – it is the most frustrating, infuriating part of the job, for me anyway.

It happened recently. A long-term, 30-something, much-liked patient of mine who comes in very regularly with a range of chronic problems, including chronic pain, had had a fall and fractured her arm. It had been treated at ED and all indications were it would heal within the usual time frame. Her arm was in plaster, but she was not coping well.

Medically she was fine. But psychologically she had convinced herself this latest incident was further evidence that life was out to get her and that she didn’t stand a chance.

No matter what I said she refused to acknowledge a single positive thing in her life – of which there are many – and everything I suggested was met with a shrug and an accusation that I didn’t know what it was like. What I really needed to do was break this “habit” of seeing the negative in everything.

I was reminded of this “habit” again when I read the feature on The Red Pill in this week’s TMR (See P27). While some interesting points are made, it appears some men advocating for men’s rights believe they are so discriminated against in society, they see evidence of this subversion absolutely everywhere, even in history.

When people start citing that more men than women have died in wars, and how it was always women and children saved first in shipwrecks, as examples of how women have dominated society, you have to suspect things have got a little out of perspective.

I’m sure many of these men have some very valid reasons for feeling hard done by. As does my patient. It is just when this negativity becomes all-pervasive and distorts these people’s entire view of the world, you have to ask what good can come of this? How can people ever be happy if they are in the habit of seeking out the misery?

As for my patient? I don’t know. I’m hoping, and suspecting, it was just a bad patch. It could be depression, of course, but she is on a SSRI and refuses to see a psychologist. At least she’s coming back next week.

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