“I don’t like your attitude. You’re rude, aggressive and pushy.” This was what a patient told me after an interaction I had with them in trying to make a plan for the day to work on getting them out of bed. The prior day, we had worked on it and it didn’t go well. It was one of the moments where you can tell both parties are getting fed up with one another. Tension is building because both people are not getting what they want and they are butting heads. Tension was rising I had left the appointment angry, frustrated and annoyed. I was emotional. I was upset that this person couldn’t understand the agenda I had; get her out of bed. It was a simple task and I felt she wasn’t meeting me halfway.
I spent the next 24 hours brooding over the event. I wanted to give her a piece of my mind. I wanted to tell her she was wrong. I wanted to tell her how upsetting and unfair her behavior was; that she was being a stubborn brat. “Whoever belittles his neighbor lacks sense, but a man of understanding remains silent.” (Proverbs 11:12) I had trouble falling asleep and trouble sleeping through the night. Yes, I prayed after the event, for her and for me. That didn’t help. I prayed in the morning of the second day, asking for grace and guidance of my thoughts words and actions. I thought, she must be just as upset with me as I was with her. Bottom line, we both had an agenda. Unfortunately they were conflicting; she wanted to get out of bed when she was good and ready, I wanted her to do it when it made logical sense with her pain regimen. Neither one of us could understand the other’s perspective, resulting in strife. We were both being stubborn and got upset when it didn’t go our way. “A fool takes no pleasure in understanding, but only in expressing his opinion.” (Proverbs 18:2)
The issue was even more upsetting because I knew that I had a physically clear emotional reaction; she had gotten to me. I had lost power. Yes that sounds bad, because it seems I was trying to control her. But from my perspective, I was trying to help. From her perspective, I wasn’t listening, being empathetic, or accepting the answer was no. But the trouble when working as a therapist, especially in a hospital, is that you have this balance of doing your job, which usually involves making people do things they don’t want to do, like moving when they are sick and feeling unwell or in pain, and respecting their autonomy. There is no guidebook to this, no clear but methods or strategies, because every situation and personality is different. You could say this is “art” of being a therapist. When do you push and when do you back off? When do you know when to walk away because the person has a right to make their own choice, even when it hurts them. Is this unethical because you are supposed to help them and you are not? Or is it unethical to push them to do something that is good for them, casting their own agenda aside? Again, there are no clear cut answers.
So could I have done something better? Something different? Sure! But what? Maybe initially sitting down and explaining my agenda “I’m here to make a plan for your mobility when you’re in the hospital. What are your thoughts?…Unfortunately, my job involves you moving despite your pain. We have worked with the team to get you the things to reduce your pain and while this is supposed to work, it’s likely you’ll still have a lot of pain moving. What are your thoughts? Our goals are at odds; how can we work together to move forward?” Instead, I am usually saying things like “The doctor wants to get you moving.” or “I’m here to get you up.” I explain what is going to happen but I don’t really ask; I tell. I tell them what’s going to happen. Not much of a choice so can I blame them for getting upset?
So maybe adjusting the approach. Will it work every time? No. Will I still be aggressive and pushy? Probably. But also, I’m not perfect and don’t have to be. Not everyone will respond well to my approach and I can’t expect that of them or myself. While I continue to muster up my empathy, which is difficult for me, I will be challenged in these situations. I can’t control what happens to me but I can control how I respond. Further, if I have an emotional reaction to everything that is said to me, I will continue to suffer. True power is sitting back and observing with magic. True power is restraint. If words control me, that means everyone else can control me. This is about control; controlling my thoughts words and actions. If I can’t do that, I don’t have power over myself. The situation controls me. So I ask for God to guide me in this. One of my crosses to bear.
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