Scapegoat to Partnership

I work with children and fairness is a big thing that comes up in play. When there is a sense of unfairness, soon after follows blame. What I have noticed is that the children need support with responsibility, empathy, and communication. When these skills are not developed, the children stay in this vicious cycle of, “I want to play with you, but if the relationship is unbalanced, leading to my needs not being met, then I want to blame you.”

I find this same cycle occurs in adult relationships including patient-healthcare practitioner partnerships. We are living in a time where patients or clients have more access to information and therefore want more choices and more explanation. Western medicine has operated for many years under the “we know best” model, where patients mainly give their power away and it is expected they follow the doctors’ recommendations. There is also this theme of Western and Eastern medical professionals working in divide, which further complicates the healthcare practitioner-patient relationship since many patients are now wanting to explore what both fields have to offer. This imbalance in the relationship leads to further dis-ease, making patients sicker and healthcare practitioners working in defense versus in openness and collaboration.

What’s troubling about these scenarios is that they are vicious cycles that show a lack of responsibility, empathy, and communication. We would all benefit from stopping this cycle and creating a more productive and integrative approach.

Lets start with responsibility. As a therapist, I’m upfront with my clients about my responsibilities and their responsibilities. Some are written in policies and some are discussed in person. My job, as the therapist, is first and foremost to think, “How many I serve you? What knowledge has been gifted to me that I can share with you to better your life? What are the possibilities available to help you?”

What I feel is not productive is, “You are 100% responsible for yourself and if something is hard and goes wrong, that’s not my problem.” Would you want to play or be friends with someone that is going to bail on you during times of difficulty? Would you want to keep playing with someone that manipulates the rules so they can ensure a win every time for themselves? To me, that sounds like a misuse of power and attempting to get out of responsibility.

Of course, the client has to make all final decisions. Of course, the client needs to get to know themselves and develop a better sense of their needs. Of course, they need to make some attempt at recommendations. It is a two-way street. However, maybe they don’t have interest in studying health like you. Maybe they don’t know how to clinically think about their situation. That is why they came to you! We are all gifted in different skills and thank goodness or it would be pretty hard to survive here on Earth. So, it is important that the patient is not left feeling blamed or shamed for a compromised immune system, a genetic make-up, a neurological difference or simply not being able to figure out how to solve a problem. Healthcare practitioners should be ENCOURAGERS and LEADERS!

Empathy is another piece and it important in a partnership. Being the helper or the patient, both have there challenges. As the practitioner, maybe they don’t have the answer yet, but they are willing to keep trying different methods and researching alternative options. Maybe they have something going on in their own personal lives. Perhaps they are working in a system where they don’t feel allowed to expand their thinking outside a set of choices. As a patient, maybe they don’t have a support system encouraging them to change. Maybe they don’t have the means to follow through with recommendations. Maybe their illness is robbing them of energy resources to go the extra mile. None of us want to be dealing with tribulations, but they are indeed part of life. So, whether big or small, we need to have patience and understanding with one another.

Lastly, partnership requires good communication. It’s amazing how learning new phrases and building up your word bank can improve your relationships. For instance, you may hear from the doctor, “Wow, this is the worst test I have ever seen!” They may say, “You’ll have this the rest of your life and there is nothing you can do about that.” How is that helpful? How about, “These test results have me curious about looking into this avenue. I’m thinking we should try x,y, and z.” The doctor can say, “I don’t  know the outcome for you. With this condition we haven’t found permanent, reversible solutions yet. However, we are learning more every day and we are going explore all that is imaginable to get you well. We are going to face this together.”

A partnership is an investment. It is an exchange of effort and belief in one another. It’s searching beyond what you know and looking for solutions in the places that you don’t even know exist. It’s reconfiguring the situations into something fruitful. It is about the patient returning back to their wholeness, leaving the practitioner in a better place before your journey together, preparing them to take the journey with the next patient. We get well when we get brave, when we have faith, and when we move beyond the discord and into possibility.

So, let’s get away from fear and move towards doing what is right. Let’s act with discernment and love. Be that person that is going to walk alongside others in good faith. Be that patient, that believes in themselves and knows that healing is there for the receiving. Be that walking miracle in all you do and then spread it to those around you.

Michaela E. Gordon, OTR/L

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