For a person in pain, the hope of a simple fix colors all aspects of the healing process, from conversations with care providers to personal decision-making. As physicians, how do we effectively communicate with the relief-seeker? What if stress and distress are important aspects of the problem, but that fact seems preposterous to the individual?
When stress or despair turn physical, it can be hard to accept, believe or even consider. Yet, all physical experiences are mixed with thoughts, emotions and behaviors. Everything physical is also psychological. Though most people know that the mind and body are entwined, it is easy to be offended at the idea that mindset is a key component of illness.
Feelings Are in Everything
The word psychology implies a broken mind. But psychology is just another way of talking about how the human mind works — how feelings intersect with thought. One key to reducing shame and stigma is to understand that feelings are in everything. Conflicts and discomforts are a given. Naming and accepting them leads to better decisions — decisions imbued with our true values and desires. This may seem obvious, but it is common to critique, judge, externalize or project feelings which lead us to“miss the boat” on our own preference. When the mind neglects an individual in that way, leading them to actions that “go against the self,” it can cause tremendous inner turmoil.
Though rational thought, logical progression of ideas and pattern formation are exceptional human attributes, isolated from inner feeling, they are not always reliable. We can talk ourselves into and out of things; we rationalize, deny, find a logic that fits us or a story that suits us, even if it is not accurate.
Magicians manipulate our rational thought to create illusion. We do the same to ourselves. Sometimes we tell ourselves a story about our illness that makes perfect sense but is not true. We might believe it because it creates a sense of certainty or control and fits a familiar tale.
If our physician tells us that things are not as they seem, it can be unsettling. If our doctor does not offer the needle or operation, we might feel bereft or unworthy. We need something to hold on to, believe in, take home, take in. Otherwise, we can become depressed and disgruntled.
The Physician’s Role
Our job as physicians is to identify options — surgical and otherwise — for getting and staying healthy. There is always something to offer. Acceptance, adaptation and life-affirming behaviors (such as exercise and engagement in an absorbing task) reduce symptoms and limitations. This is resiliency and it works. It is science even if it is not logic. No matter the physical change or circumstance, there is always a path forward. Helping people embrace this abstract approach — resiliency — can improve longevity and quality of life. Getting better at explaining how and why resiliency will deliver as well as (or better than) a procedure is crucial for our ability to treat. Resiliency also improves the results of procedures and speeds recovery. Resiliency is good for you.
For each person, the path of care is different. Receptivity to unfamiliar, unexpected offerings such as a self-care/resiliency plan can be a challenge. People resist, understandably so, because the association between mind and body matters can be indirect and mysterious. Resiliency can deliver a delayed gratification — it takes time to see results — but ultimately provides a special and invaluable something.
Empathy and flexible communication — being able to adapt the words and the delivery style to the individual — can help create an optimism and motivation in the person to address things differently. Receptivity to resiliency can save a person from chronic despair. Once it becomes habitual, it can be a daily “fix.”
Even if the problem cannot be sutured, it can still heal.