Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Public Enemies

enemiesThey are not your enemies. If you are encumbered by resentment of patients, seeing them as inappreciative, uncooperative, manipulative…you are likely a victim of their displacement. This process occurs when an individual is unable to express an emotion toward the targeted person and, instead, expresses it toward someone who is perceived as safe. Your boss frustrates you, and you come home and yell at your spouse. Your spouse angers you, and then is harsh toward your child.

Similarly, patients can harbor a great deal of anger and resentment. While they could yell at the true culprits/enemies, it is not necessarily safe to do so because they can just as readily be abandoned by these individuals.

Their tests are not being authorized, their prescriptions are not being filled. As a patient you can, and many do, express this frustration toward their insurance company, but is it safe to do so? Is there not a risk in expressing anger at someone you actually need?

For some, the only safe outlet is the person providing care and support. The nurse and the doctor, after all,  not the true enemies although they “should know” the pain, difficulty, frustration and emptiness of the physical complaints. Some patients hope that this acting out will evoke concern, warmth, compassion and support. Of course, it most often does just the opposite.

The response in such cases is a rather direct one: “Clearly you are angry, frustrated and disappointed. You are expressing these feelings toward me, but I believe that you know that I am doing all that I can. If you can tell me with whom you are truly angry, I may be able to offer some advice and direction. However, if you drive me away, then you are left even more alone.”


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