COMMUNICATION SKILLS WITH (AND FOR!) PATIENTS
AND FAMILIES. AND OTHER HEALTH PROFESSIONALS..ON
THE HEALTH CARE TEAM
Oh yeah, feel free to use them at home,
too.
ASSERTION is an attitude... A commitment
to positively rather than aggressively
challenge issues or not face them at all.
Communication is honest, concise, brief
and direct, with good listening skills,
acknowledgement, empathy, non- defensiveness,
the ability to request what you need and
positive reframing (seeing and accentuating
the positive).
Joe is a 54-year-old type 2 patient
with diabetes who reported that he consciously
ate more than he might have in front of
the family, daring them to judge him silently
or to his face. It gave him a strange
sense of power to defy them, expressing
his resentment and hostility through his
behavior. He was, perhaps, scapegoating
his family rather than feeling his fury
from the fears and restrictions of diabetes.
His sister Jane, age 52, reacted to his
overeating with alternating bouts of rage
and coldness. It was more difficult for
her to feel sadness and fear about what
he had to go through and easier to be
angry and controlling. This is an attempt
at an assertive dialogue between them,
after Jane criticized Joe for not taking
care of himself.
Joe: This is none of your business. I'll
do what I want. You can't control me.
Jane: My interest in you, my questions
feel controlling? (LISTENING means you
can repeat back what you heard, clarify
and then check for accuracy in your understanding
by asking a question.
Joe: It sure does. You, the doctors,
my wife...I don't have a life.
Jane: That sounds awful for you. (ASSERTIVE
EMPATHY)
Joe: Thanks. It is. I feel like my privacy
is gone, like everyone is free to intrude
on me the first moment I do something
wrong. I've always eaten terribly and
with all the anxiety about this illness,
I can't seem to start changing my relationship
to food now
Jane: I'm so glad you're telling me this
(ACKNOWLEDGEMENT NON-DEFENSIVENESS). I
don't want you to do this alone. Can we
figure out some way that I can be your
friend and not a critic? (ASSERTIVE REQUEST.)
Joe: Maybe, but don't get carried away.
WHAT IS THE PROCESS OF ASSERTION
In the ASSERTION process, it becomes
necessary to RECOGNIZE and respect the
feelings of yourself, and later others,
as the first step.
The next step is to DESENSITIZE you.
This means taking the sting out of your
feelings by stepping back from them-detaching-and
adding a rational component. Think of
deputizing yourself as a therapist in
order to try to objectively rather than
reactively respond.
A third aspect is to ANTICIPATE that
life is filled with "situations"
and we all must have "mental muscles",
be in good shape to handle all the challenges.
The final step is to PREPARE for what
we anticipate so we are never caught off
guard and can handle the events or people
who throw us off guard. (We check to find
out what the weather will be and determine
what shoes we will wear for the expected
rain or whether or not we will bring an
umbrella.)
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