Expressing My Needs - Why Bother?!

[scout86]

I'll second "getting mad". After my last experience with the medical profession, and the discussion with my T (who told me that bunch was SUPPOSED to be rated as very good), I went out to the clinic's web site and found that they have a form for rating your experiences with them. So I did. I GREAT detail. I actually got a phone call from their 'customer service' dept. We had a rather lengthy and detailed conversation about my experience. I wasn't going to mention the whole PTSD thing. But then, some of the things that bothered me are related to that, and I'm not the ONLY person in the area with PTSD, and they CLAIM to want to do a good job........ So I described the whole experience, from my point of view, starting with 'it's not clear where you are supposed to park and there isn't a sign on the door to indicate which door you should go in.' (She was surprised to realize that's the facts. Doesn't matter if you know your way around, of course. :mad:) I explained what it's like to walk into a large open area, full of people, surrounded by an assortment of alcoves and doorways, and hallways to somewhere, feeding into the area. And then there is NO SIGN even telling you which way to go (while you're trying to do a threat assessment.:banghead:) By the time I finally got where I was going, it was probably just lucky no one got hurt.:rolleyes: Needless to say, she'd never thought about all that (why would she?) and no one else apparently had either. I then asked how many combat vets she figures they serve (a lot) and speculated that there are plenty of people in the community who don't make it past the front door. She gave me the feeling they appreciated the info and might make changes. I'm not holding my breath and hope I never have to go back! :bag:

 

[Deleted member 541]

Life/living is about needs. Without them you can't live. Wants, for me are more about personal things. But needs I can't live without.

 

[Sideways]

Otherwise people ignoring /dismissing just reinforces that what I want doesn't matter?

That's your head giving you a skewed interpretation of what their response meant on that occasion. It's an interpretation that reinforces the more comfortable status quo, "I don't matter, so don't speak up" so it's likely going to take some time for your brain to practice, and eventually accept, different alternatives.

In this one situation, you didn't get the result you were after. And there will be times where that happens. But there will also be times where what you ask for is totally fine with the other person, and they'll accommodate your priorities so easily that you may barely even notice it was a big deal.

To the doctor, "I need to know before you touch me" may not be something that doctor prioritises. So, this is a situation that you're not going to want to be in very often, or it mat motivate you to try a different doctor, ask more loudly, change, whatever.

But if it had been your personal trainer, for example, and you tell them "Tell me before you touch me": same need, but damn straight you're tonna expect them to 100% no-compromise accommodate that, or you'll find a new personal trainer and potentially go to the police with an assault charge in mind.

When we're training our brain to think differently, interpret things different, virw ourselves and the world around us differently, our brain is going to habitually defer back to what we're used to. In this case, your brain is used to interpretting things through its "I don't matter" glasses. Changing that, takes time, practice, and persistence.

Eventually, with enough practice, you tell someone "These are my needs...", and your brain is comfortable with that. It becomes the norm. So when people don't respect what you've told them, your brain will, of its own accord, look for solutions to that hurdle without just defaulting to the old "I don't matter" pattern.

"I don't matter" is a belief that your brain learned to look after you, but it's not a helpful (or accurate) belief now. But just like Brain didn't learn "I don't matter" overnight, learning "I do matter" will take time.

Stick with it. You do matter. This is not evidence that you don't matter. This is evidence that (for all sorts of reasons, often not to do with us personally at all) it doesn't always come easy, or go the way we'd like. That's not a reason to give up. So don't give up.

 

[Keming]

if we don't know or cannot quantify 'what we want', it's very difficult to figure out why we want it. Why matters.

 

[Freedomfighter]

I often have difficulty 1) knowing what I need and 2) expressing my needs to others. I know that plent...

Your post saddens me, because what you describe is not just nice to have but rather consists of needed support, the patient needs to be able to vocalize which stressors can be eliminated and how to be more comfortable, when health care personnel either avoids such discussions or even makes you feel embarrassed about such a need then it is them who should consider empathy training.

I am always taken back by how unprofessional health care employees can be, which was demonstrated rather well by a so called health care provider that thought it was nothing to sexually harass a patient when I went to a yearly female check up.

 

[EmmaOwl]

it was difficult to ask because I felt silly and needy and embarrassed. But I asked. And asking felt like some kind of achievement.

But then, having asked, I didn't get.

by asking, I am always therefore potentially setting myself up for disappointment.

It is an achievement to ask. Yeah, it might not work out, that's true. But if you don't ask, you'll NEVER get.

 

[barefoot]

Thank you all for your thoughtful, supportive responses. Sorry it's taken me a while to come back to this thread - I was feeling a bit upset about the whole situation so decided to give myself a bit of space around it.

I've just re-read all your replies and there is certainly useful thought here for me, which I appreciate.

Some particular bits (quite a few - apologies for long list!) I want to acknowledge/pick up on:

It feels much easier and more comfortable to take all the responsibility back on ourselves, and make ourselves at fault for asking at all.

Yes, I think there is an element of this...if I don't ask and don't get, that is my fault and something I am in control of. And that feels more comfortable than letting someone else have the responsibility/control. Even though I realise that, as some of you have said, if I don't ask I absolutely won't get, so that isn't a very satisfying place to be in.

E.g. I am currently waiting for my therapist to get back to me with a time for us to do a phone session. I can't physically get to her at the moment because of my surgery so we were going to have a break until I was mobile enough to go in. Then the shit hit the fan at the hospital in a way I didn't expect and I've felt very upset and shaken by it, so I emailed her to let her know. A. Week ago, she suggested a phone session. A week ago, I said yes please because I really wanted to talk it through with her asap. A week later, I am still waiting for a date for that phone session. She emailed on Saturday to say it was taking some time for her to work out when she could do it and asked that I leave it with her and she'd get back to me when she had a firm time she could offer. I am not convinced that we are going to end up having this phone session. So, at the moment, I am feeling a strong urge to email her back to say not to worry about it and I'll just wait until I can make it in to London to see her. Not really because I don't want the session (although the emotional intensity and therefore the urgency to talk things through with her have reduced significantly) But because I would much rather be the one to take the phone session off the table instead of her ultimately now saying she can't or just keeping me hanging when she's not going to follow through on what she offered.

Because getting what you want doesn't mean that you matter, and not getting what you want doesn't mean you don't matter. How much you matter has absolutely nothing to do with what you want or get.

That has blown my mind a bit, seeing that link I'm making written down!

I kind of got hung up on "What am I doing wrong?" (Because, if there's something wrong here, it had to be me, doesn't it?")

Yes...this is familiar! And I *do* still think I did some things wrong. Or, at least, there were things I could have done better. Things I could have persisted with. eg I *should* have kept asking for a pre-med sedative until I got one. I might not then have got triggered to the point that I did later on where I pretty much totally lost my shit with the anaesthetist and was crying, shaking and trying to get off the bed but not being allowed to. I'd asked for one in advance of the day and was told I'd be given one. The nurse then mentioned it as soon as I got there because I said I felt anxious and I said that I'd like one. And then it didn't come. And I was aware i hadn't had it and that I wanted it but there was a lot going on and the staff seemed rushed and I felt anxious...and I think I just thought they'd decided I didn't need one so then I didn't feel I could ask again. And I know that's stupid. I know the reality is probably just that the nurse forgot and if I'd have asked again she would have brought me one. But I just didn't feel I could ask again. It felt...shameful....I think, the idea of asking and asking...

when it came to self, I'd often choose the path of least resistance just to get things done and over with already, rarely speaking up for self

Yep. I find speaking up for myself very hard as I'll always just thing "oh, don't make a fuss....you're fine, it'll be fine..."

I express my wants and needs to be seen and heard, because I matter. The response is out of my hands.

I think I need to work on this! I do absolutely get that I can't control others' responses. And I also totally appreciate someone's right to not give me what I want/need - to say no or to offer a compromise, for instance. So, I suppose something I need to work on is how I manage my feelings about their responses - which includes me asking and them ignoring, dismissing or saying no (where my feelings are things like hurt, disappointment, anger, rejection, shame) and also, I'm realising, that I find it difficult when people offer to meet my needs too and I will then often minimise/deny the need, reject their offer and feel weak and ashamed.

I went out to the clinic's web site and found that they have a form for rating your experiences with them.

I've been surprised that the hospital hasn't sent me some kind of feedback form. To be honest though, I don't think the anaesthetist did anything majorly wrong. He'd obviously forgotten the info he was given a heads up on and agreed to in advance. I don't think he handled me very sensitively considering the state I was in. I suspect he was just trying to knock me out as quickly as he could because I was in such a state - which probably makes sense but it was a pretty horrendous experience for me. I think those things are probably unfortunate. And I think I failed to manage myself very well. So, I don't think I really have grounds for a complaint. It's not his fault that I'm still struggling with a doctor-related thing from when I was a kid and that I ended up being very triggered. It's mine.

don't matter" is a belief that your brain learned to look after you, but it's not a helpful (or accurate) belief now. But just like Brain didn't learn "I don't matter" overnight, learning "I do matter" will take time.

It's interesting because I've never thought I have "a thing" around me not mattering. But a few of you have picked up on it here. And, thinking on it, it has cropped up a few times lately, the idea of what I want not mattering. And if what I want (or don't want) doesn't matter to people because they will do what they want anyway...I suppose that does boil down to me not mattering...

 

[scout86]

He'd obviously forgotten the info he was given a heads up on and agreed to in advance.

Not to freak you out with bad things that didn't happen, but just to show you why this part of his job is important. Suppose that bit of information he 'forgot' was that you have a dangerous drug allergy? That's not what he forgot, thankfully, but keeping track of that stuff is his JOB and it's potentially life & death.

It's not his fault that I'm still struggling with a doctor-related thing from when I was a kid and that I ended up being very triggered. It's mine.

I disagree. They had enough information to know there was an issue here. They may have chosen to minimize it, but you had given them a heads up.

I shoe horses for a living. When I encounter a horse who's fearful, it's MY job, as the professional (and, best case, the owner's job) to calm his fears and make the experience as ok as possible. Because I'm the one who's supposed to know what I'm doing. Because it's not my first rodeo and I've dealt with fearful horses before. The horse? He's probably only dealt with being scared before! How is it reasonable to expect him to suck it up and deal with it? (It's not)

Your fears are real. They came from somewhere. You didn't make them up to be obnoxious. My guess is, you'd do about anything to have them gone. But you aren't there yet. IMO, your 'job' in that situation was to let them know you had concerns, which you did, and then to deal with them as best you could, which you also did.

There are a lot of people who have 'doctor related issues'. I hardly think you are the first patient they've met with fears like this and you won't be the last. The world would be a better place if they'd learn better ways to deal with it.

 

[Tinyflame]

It feels worse to ask and then have it ignored/dismissed/discounted than to have not expressed it at all.

It just feels more shameful to have asked. Like, I shouldn't have asked because it doesn't really matter.

I just felt scared and humiliated.

And if the world didn't end, it was manageable. So I can't have needed it that much anyway. So it can't have been very important. So I shouldn't have asked for it in the first place.

Yes I understand that. ^^^

Not sure entirely about wants vs needs, but generally i only express needs, since some things relate to my incapabilities. Or trying to pull myself out of the pit. Ugh, don't have the words.

Actually the truth is we aren't that important to some people. Maybe one day we will meet people we are.

Yes it is degrading, and worse than not trying, because trying includes hope. Or 'feels' degrading, they would say?

Hope it becomes easier @barefoot . :hug:

 

[Tinyflame]

Ps, hope you heal from your surgery quickly, xox. :hug:

 

[barefoot]

keeping track of that stuff is his JOB and it's potentially life & death.

Yes, I hear what you're saying. But these weren't life or death things. They asked questions at the time on the day - as well as in questionnaire form in advance - about life and death stuff like allergies, other medical conditions, any current medication etc.

The things I had flagged in advance were not life and death. They were:
- I have some issues with doctors/medical stuff so how can they help me manage my anxiety on the day before the op (answer came back in advance that they would give me a pre-med sedative)
- I have PTSD and am not great with touch and I don't want to get spooked (e.g. If I'm woozy and disorientated after an anaesthetic) so I asked if they could explain things to me before they did things and to ask/let me know before they touched me. (Answer came back that the anaesthetist had now been informed of this and could I let the nurses know when I get there)
- I have some reactions to some strong pain killers (not life threatening - they are generally sleep-related) so I wanted to try to ensure I got a combination of medication that would work well for me. (Answer came back that the anaesthetist would talk me through this on the day to ensure we come up with a good solution)
- I have night terrors that sometimes mean I leap out of bed and start running and then generally fall over, so I was worried about this happening in the couple of weeks post-surgery when the healing was in early stages of recovery, in case I fell and did some damage. (Again, the answer came back that the anaesthetist would talk me through this on the day to see if he could come up with a potential solution.

I'm not saying these things to be argumentative with you, so I hope it doesn't come across that way. And I'm not saying they weren't important things - to me, they were. I guess though, because these are not life and death things, perhaps from a busy medical practitioner's point of view, they are just not considered particularly important and are therefore pretty forgettable?

you had given them a heads up.

I had flagged all this in a long conversation with the surgeon's PA a couple of weeks before the surgery. She was lovely and very reassuring. She then had a conversation with the anaesthetist about all these points, plus, before she spoke to him, she asked me to email the points and she also forwarded that email to him so that everything was clear and accurate. Then she emailed me back to confirm what she and the anaesthetist had agreed (e.g. I can have a pre-med, we would talk through pain medication, he knew he had to warn me before touching me etc)

Believing all that was in place, I felt much calmer in the run up to the surgery date. But, in retrospect, I think I was naive in believing that, because he'd been told about it and been sent an email about it, those things would be on his radar on the day. I assumed he would remember and/or have read through notes before he met me. I now see that's not how it works!

I think where I fell down is that I didn't then speak up about all those things when I saw him on the morning. I did mention the things about pain medication and night terrors. But I don't think I mentioned about the pre-med and the touching thing to him. So, I think that is where I went wrong. I was just so thrown that, when I mentioned that he'd spoken to the surgeon's PA and been sent an email from me, he looked completely blank and when I then started talking about the medication/sleep stuff it was clear that it wasn't ringing any bells for him.

So, I should have said everything again. All four of the above points. But I felt anxious and flustered and he was asking me about spinal blocks and I was having to make a decision, which I hadn't expected and he wasn't even explaining what a spinal block was apart from saying it was "better to have it in terms of pain relief" so I said ok even though I didn't know what I was saying ok to...and it was all....a bit much. Ugh! Getting teary just writing about it!

So....yes....I had given a heads up. And I had been very clear and thorough and open with that. But I then failed to properly follow up on the day. I guess that is a learning for next time...But I don't know whether/how I would actually be able to do it differently next time...

it's MY job, as the professional (and, best case, the owner's job) to calm his fears and make the experience as ok as possible.

Yes, I see what you mean. My emotional response to how it went is that I cannot fathom how a medical professional would respond to a patient who was clearly in a high level of distress by shouting at her to calm down, holding her down so she can't move and then starting to pull her gown down (he didn't explain why to start with, he just started exposing me, then the nurse said they needed to stick the heart monitor pads on my chest) while she was in the middle of losing her shit. It is upsetting to think about it. But then my rational brain takes over and says that they seemed in a rush and I think they maybe just wanted to get it over with by getting the anaesthetic in me (and therefore making me unconscious) asap. So, perhaps they were actually trying to help me?They just weren't very sensitive about it.

IMO, your 'job' in that situation was to let them know you had concerns, which you did, and then to deal with them as best you could, which you also did.

Yeah...though, again...I don't think I did enough on the day itself. I trusted that he knew stuff and had agreed to be a certain way with me. And when it was obvious that he hadn't remembered that, I didn't explain it all fully again. And, you know, maybe that wouldn't have made a difference anyway. I just feel a bit of an idiot that I didn't do that. But I also know my anxiety was rocketing at that point and my brain wasn't really working very well...so maybe it was the best I could do in the circumstances. And that's why I flagged it all in advance - so I could do it calmly and clearly and not having to try to explain stuff in the middle of having a meltdown.

The world would be a better place if they'd learn better ways to deal with it.

Yes, absolutely. I don't believe he meant any harm. I'm sure he's a nice man and a good anaesthetist. But, as you say, they must see nervous patients every single day - and then also people with more ramped up/layered anxiety too. It is astounding to me that they can't deal with people better.


Thanks for your thoughts in this thread. I feel like I've just derailed it a bit by writing about the experience as opposed to the OT of expressing needs. I think I must have just needed to put that somewhere!

 

[barefoot]

@scout86 Your job sounds very cool btw. We used to have horses when I was a kid and I used to love it when the blacksmith came. I used to sit and watch in absolute fascination :-)