DISTANCING BEHAVIOR
Distancing
behavior by professionals discourages patients or family
members from disclosing their real concerns.
Some
examples of this behavior are:
-
Selective
attention
-
Normalizing
-
False
reassurance
Selective attention – When a patient mentions both
physical and psychological problems, many doctors and nurses
will focus on the physical.
Normalizing attempts to reduce the importance of
something. (“You’re bound to feel upset, everybody does in
your position.”) This protects the carer from his own
emotional responses of anger, sadness or fear.
False
reassurance (or premature reassurance), with the excessive
use of positive statements or unrealistic promises also blocks
the patient from sharing fears. False reassurance destroys
trust. (see Trust,
Reassurance)
Non-verbal distancing behavior – The most powerful
messages are given non-verbally.
(see Non-verbal
Communication)
Gestures which may convey your intention of keeping emotional
distance include:
-
Handshake
with palm down
-
Poor eye
contact
-
Looking
away or eye closure
-
Body
turned away
-
Feet
turned away (if standing)
-
Chin down
or neck rubbing (conveys criticism)
-
Barriers
(desk or any object held in front of the body)
-
Arms
folded across chest (conveys suspiciousness)
-
Displacement gestures (picking at clothing)
-
Territorial display (leaning on furniture)
Clusters
of signals convey attitudes and feelings rather than
single gestures. While some gestures are culturally
determined, many are nearly universal. Eye contact (normally
60% to 70% of the time) and facial expression can convey
openness and acceptance, but the above signals may detract
from that impression.
Health care
professionals often work under considerable pressure. They
fear being overloaded with the problems of patients and
families, which can often re-awaken powerful personal
emotions, and which can tap their resources, both personal and
professional. Thus they sometimes wish to “keep their
distance”.
Health care
professionals (and volunteers) must be encouraged and helped
to deliver good care. Careful selection of staff, proper
training in communication skills (demonstrations, role play,
video feedback), good staff support mechanisms, opportunities
for continuing education, and proper structuring of the
workload so staff in the front line of caring for the dying
and bereaved get time away on a regular basis, all help carers
to respond appropriately to the concerns and needs of patients
and families. (see
Burn Out)
The author and publisher have taken
precautions to ensure that the information in this book is
error-free. However, readers must be guided by their own
personal and professional standards of good practice in
evaluating and applying recommendations made herein. The
contents of this book represent the views and experience of
the author, and not necessarily those of the publisher.
