Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression


compassionThe helping professions were, at one time, recruited from those who made the declaration that “I just like helping people. I have compassion.” That perspective, academic grades and admission test scores would be instrumental in getting into nursing, medicine, etc. The youthful enthusiasm of taking on the emotional burden of suffering individuals does, however, take its toll.

Regardless of one’s efforts, there are simply far too many patients and far too much suffering. To attempt to assist them all begins to feel futile with passing years. This mounting frustration presents as irritability, impatience, being curt and short-tempered.

There are three realities that we as patients rarely perceive and yet as providers we cannot understand how patients do not understand:

a. A range of patients seen on the same day will consist of those whose problems are minor to those whose problems are potentially catastrophic. Responding to all as though they are of equal weight is not possible.

b. Patients will focus upon problems even when the problems are self-created with the expectations that outcomes can be changed by a provider even though the patient has no intention of changing the behavior creating them.

c. Patients expect solutions without fully disclosing the problem; providing what they feel is just enough to evoke compassion but not enough to lead to a productive treatment We operate from the perspective that I am paying for your compassion, and you, therefore, are expected to have a ready and endless supply to dispense.

In 1992, this was labeled “compassion fatigue (with its) “deep physical, emotional, and spiritual exhaustion that can result from working day-to-day in a care giving environment.” This becomes the cornerstone of OCCUAPTIONAL BURNOUT. One cannot satisfy the emotional demands of every patient, and it becomes increasingly frustrating when patients do not wish to help themselves.

This is compounded by the cases that cannot be solved, appreciation that is rarely expressed, decreased patient loyalty when patients shop for price, location and, far too often, access to drugs.

“Compassion fatigue is furthered by the health care provider’s personal health, family relationships and financial concerns that then emerge during patient interaction. The solid reputation of the provider is then marred by this bad-day-phenomenon, and as human beings, we tend to revel more in spreading bad word than spreading good.

We also, as a group, tend to be non-forgiving. “S/he was rude if not nasty; why should I bother to go back there for help.” It is more functional, and quite frankly more accurate, to perceive a healthcare provider as an individual with unique skills and intended compassion, but that we as patients can rapidly deplete both.

Atlanta Medical Psychology

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