Over the course of your life with rheumatoid arthritis (RA), you'll interact with many doctors, pharmacists, physical therapists, occupational therapists, lab technicians, and the guardians of them all, the receptionists. There may be a time when interpersonal issues arise, which can have a negative impact upon your quality of care.
When you visit a member of your health care team, you expect to be treated with respect and dignity. You have the right to ask questions, share your fears and concerns, and ask for another opinion, or treatment plan. However, there may be times when personal dynamics (body language, facial expressions, tone of voice, and word choice) derail a meaningful conversation.
When relationships start to go sideways, the best place to set it right is from a place of good emotional management. The one person you have control over is yourself.
I learned a valuable lesson when I wasn't in the best of moods when I went for a haircut. I was tired and sore, and I just wanted to get in, get clipped, and go home. I've been seeing the same hairdresser for about 20 years, and I've always been happy with my haircuts, except upon that one occasion. What changed? Upon reflection, I realized that my hairdresser picked up on my mood, or energy, which probably made her nervous, or less confident. The result: a bad haircut. The lesson: take some time to manage my emotions before going for a haircut.
You are an integral part of your health care team. To get the most out of your appointments, here is a template that can help you build, stabilize, and/or improve interpersonal relationships:
1. Learn emotional management/stress skills. Prior to the face-to-face contact, do as much as you can to get into a place where you can effectively express your needs, and voice your concerns and fears. I often do this on the way to the appointment, and while sitting in the waiting room. Slow down your breathing. Use your diaphragm. Spend some time thinking about who/what you love. Ahhhh Don't you feel a little calmer, now? Isn't that a better way to start an appointment?
2. Prepare in advance. Bring in a sheet with your questions. If you've had adverse effects from your treatment, record the date and the symptoms.
3. Listen to understand. Conversations can stall when one listens to respond, rather than listening to understand. Give your full attention to the speaker. Pause. Think. Respond. Practice this skill with the next person you speak with. How did it change things for you?
4. Clarify. What you think you hear may not always be what the person said. Here is a quote that illustrates this point (original source unknown): “I know that you believe you understand what you think I said, but I am not sure you realize that what you heard is not what I meant.”
5. You do have the right to express how you would like to be treated. During a hospital stay almost 30 years ago, a doctor was quite rude to me because the nurse couldn't get a vein started for an IV. All this time has passed, and I've not forgotten how helpless I felt. He may have been having a bad day, or maybe even a bad life. If I could go back in time, I’d do things differently. I would have pointed out that I was polite to him, and would expect him to afford me the same courtesy. The beauty of hindsight!
6. It's not about one-upmanship. In a disagreement, you sometimes lose sight of what's important. In this case, it's about getting the best care possible. It doesn't mean that the person who speaks more, or yells louder, wins.
7. Humor. It's a good tool to use to defuse a conversational bomb. Maybe you're not known for your comedic talents, but you might be able to see your way forward by using a little self-deprecating humor to clear the air.
8. “I” statements. In the book Nonviolent Communication, author Marshall B. Rosenberg reminds you to dig deeper to connect your feeling with your need. By doing so, you can deepen your awareness of your own responsibility in the act of communication. For example, “I feel afraid because...[state your unmet need].” You can practice this with your family. “I feel disappointed when you don't tidy up, because I feel better when everything is in its place.” You may encounter people who disrespect the rules of the “I-game”; in that case, go back to the first point in this list, and manage your emotions to find a way forward by using the suggestions in this template.
9. Thank you. This little phrase can carry a lot of weight, especially if you take the time to specifically express what you're grateful for. It's important for you and for your health care team to let them know that they make a difference. An attitude of gratitude is good for your health, as explained on page 105 of The HeartMath Solution:
“You can be confident that as you focus on sincere feelings of appreciation, your nervous system will naturally come into balance. Biologically, all of the systems in your body, including your brain, will work in greater harmony. The electromagnetic field radiating from your body will resonate with the ordered, coherent pattern emitted by your heart. And every cell in your system will benefit.”
10. Advocate. There are many opportunities available today to advocate for patient rights. Within the hospital setting, patient navigators are often available to offer their assistance by providing guidance through the medical maze. Either become an advocate yourself, or make use of one.
11. Document and escalate. If you've tried your best to resolve the issue, and you feel you are not getting anywhere, document your concerns, then take them to the next level.
12. Go “shopping.” If you are fortunate to live in a large enough community, you may be able to replace the problematic health care team member with one that is better suited to your style.
Interpersonal issues can arise any time you have two or more people together. Do what you can to conduct yourself in as dignified a manner as possible by systematically implementing the above suggestions. You'll feel better, and as a result, will be better-positioned to resolve the issue in a favorable manner that is good for all concerned.