Empathy Over Ego: the art of active listening as a health professional

picture grid for empathy article

Sincere empathy can be a challenge for many healthcare professionals because we are confronted with an endless stream of people that have encountered horrible life events and we can’t possibly begin to understand the psychological stressors that they are now facing, either real or perceived.  Many of us work in healthcare models that give us very limited time with a client due to the volume of people we are trying to help and/or the financial constraints of who is paying for our time.  The combination of these two factors doesn’t usually result in a positive experience for patients trying to navigate through their medical system armed with only a very superficial knowledge of their bodies.

Our medical systems are typically very good at keeping people alive, but after that they can become a series of very stressful life events that cause just as much harm as good to a person’s psyche. People that find themselves caught in a cycle of chronic pain are the prime example of how someone can do everything right in their search for help, but end up having the process actually cause more harm than their original injury.  Chronic pain is a combination of entangled physical and psychological stressors that shifts more and more towards the cognitive side as time passes.  Every new professional that a patient sees and has to tell his story to without receiving some form of empathy and/or meaningful explanation further feeds the fire of fear, stress and anxiety related to his pain.

Healthcare professionals are trained to first and foremost screen for ‘red flags,’ or signs of something more sinister than a simple muscle strain.  Physicians have the most knowledge and experience of the various sinister conditions and because of that fact their approach to dealing with less threatening issues like low back pain can become both less useful and less empathetic.  When you are trying to rule out tumors and aneurysms your attention to other more relevant details of a person’s problem may be suspect.  Unfortunately, most chronic pain issues are multifaceted in nature, but most doctors are highly specialized in their training.  Patients end up getting referred to these highly skilled physicians like surgeons that can only address one part of the patient’s problem, which becomes a hard psychological strain on a person when the specialist can’t ‘fix’ them.

I work with many people that have already seen three doctors, a chiropractor, a physio and a massage therapist and then find their way to me.  People that have been through the system with pain get used to telling their story, for some it becomes their identity.  They have had different people tell them different things, diagnose them with this and that, prescribe them pills, send them for scary tests, but rarely had anyone sat down and listened and then explained to them in words that make sense why this is all happening.  No matter how good you are at your specialized skills physically treating people, you need to start by helping the person understand their predicament and what each of your roles is going forward.  The act of educating a person instead of diagnosing them is in itself an act of empathy that lowers a patient’s stress and opens the door for you to help them.

Some health professionals that become highly specialized and develop long waiting lists can develop an ego that starts to detach them from the patient that they are trying to help.  It most likely starts as a coping mechanism to create a certain level of detachment from other people’s problems, but can build into an ego over time that will most likely diminish the professional’s ability to empathize and connect with a person that needs help.  The clients that need the most empathy are those that have very emotionally driven pain, but continue to fixate on the structures that they may have injured years earlier.  Unfortunately, the deeper down the medical path patients go, the more tests they get that focus on structure and the more specialized the doctors get at treating structures which just tends to fuel the patient’s anxieties.

Primary care practitioners like family physicians and physiotherapists need to improve their skills at identifying more emotionally charged patients and educating them early on in their journey about the nature of pain and how to stay in control of the process.  Doctors and physios needs to take on an early access counseling role before their patients have accepted that counseling may be part of the process of helping them get better.  We need to help guide a person’s expectations while trying to help them and empower the person to assertively work to get better because time does not heal all wounds.  Don’t assume that doing something to a patient is always better than simply teaching them something.  Put your physical skills down and find a connection with the person first and then explain to him the tools you have to help and I bet you have a more engaged client to work with.

For a broader discussion on this topic, please have a look at my book…

As a side note, I have started to embrace Instagram as a new source of content for @WhyThingsHurt, I have been posting pictures, memes and short videos that you may find helpful, inspirational and/or funny.

Please feel free to leave any questions or comments below.

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2 Comments ↓
  • Bundoran Physiotherapy

    Hi brent
    Im so delighted to find your page. Im a physio also trained in cst based in ireland and it is wonderful to read posts from someone who gets it!! I luckily work in private practice and spend an hour with each client which gives the space to work with all aspects of the client. I tend not to get the chance to mix with physios who have cst training and find “regular” physios spend too much time engrossed in finding what structures are at fault and dont get how important the emotional side is.
    Ill be checking in regularly
    Libby :-)

    • Thanks Libby….the chance to spend a little more time with people and properly use our skills makes a big difference in the ability to see, hear and help the whole person. Glad you enjoyed the site. I am trying to start posting more often again as I free up some time! All the best

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