Anger explosion with patient
Mapping a Trigger:
Explosion on a patient
A young, fragile woman with migration backround ( literally sitting inbetween two cultures: born in Germany raised in a very conservative Turkish communitiy) sees me because of lower back pain, described as severe.
She was very friendly but also not showing any kind of bodily distress, asking for an injection against the pain.
I am the doctor, offering a sick note for work and some painkillers to deal with the pain, she insists rather friendly on the injection, which I am unwilling to administer, as this is the first consultation and she is sitting up straight without any obvious sign of severe pain.
Still she insists.
I start screaming at her, which has never happended in my entire life ever and in a professional setting is even worse, as I am supposed to comfort rather than attack my customer/ patient.
Luckily there was another senior doctor in the practise who took her over, I had to leave the room, I was in such rage and she obviously did not do anything to make me scream- so I had my senior take care of her.
He did give her the injection which had her collapse – as pain was really not the problem.
I treated her after the collapse, we did not talk about the explosion and never mentioned it again.In a supervison stetting the psychological explanaition offered was, that it was a huge projection of anger I perceived/received, could not recognize at the time and also resonated, as I had a lot of suppressed anger myself.
Trying to map the trigger which led to the destructive behaviour:
perceived event: Emotion of patient: → automatic appraisal : → Anger → screaming
anger -subconcious suppression
-precondition tiredI wonder if it was an innate trigger to answer anger with anger, although it is only felt and not expressed. Never happened again, as I am now aware of mood swings in such dimensions, from happy-go-lucky to deeply sad or raging anger starting with a new person in the room, might not be my own feeling/emotion.
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To add to what we already discussed about this, reacting with anger to another’s anger was definitely an innate trigger, but it was not alone. There is also the defiance of your knowledge and authority as a doctor there…
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