Feeling misunderstood by a care provider when there are unexplained problems (for example paralysis without real medical causes) is a painful thing for clients who sign up for examination and treatment. They are often referred to a neurologist or other specialist, but does that offer a solution? Does an MRI help? Wouldn’t it be better to listen carefully to what the client has to say and to be open to acknowledging and acknowledging a complex situation?
Half-blind
An example: a 16-year-old girl transfers to the atheneum and suddenly becomes half blind. Suddenly she can’t see in one eye and everyone panics. The first thought is that she had a stroke. But scans show nothing strange and investigations yield nothing. No one understands what is wrong with her. Until she talks to a clinical psychologist through an eye clinic. What seems? Due to stress, tension and frustration, the girl has partly lost her sight. She is back in high school. Her sight is now fine again after a human-oriented treatment and she can enjoy life again. This is an example of a medically unexplained problem where appropriate assistance has been successfully provided. For clients it is not easy, rather painful, to sign up for examination and treatment of such seemingly medically inexplicable problems. These are often people who have already visited many care providers – who are sometimes experienced as difficult – and who often switch from one care provider to another. And if they do get help at all, there are the strict rules of the health insurers that often have an obstructive effect.
Human-centered approach
The example also shows that listening to the person with the request for help and being open to recognition and acknowledgment of a complex situation may offer a solution. A correct people-oriented approach can offer the possibility to analyze several aspects of the problem. We then refer to all aspects of the human being that have led to the emergence of the situation that is difficult to interpret. You then learn to gain more insight into someone’s background, experiences, needs and thoughts. Recognizing and acknowledging them creates space for talking about feelings. People then often dare to talk openly about, among other things, shame, frustrations, fears and traumas that have arisen in the past.
Particularly in the case of unexplained physical complaints, the people-oriented approach offers more opportunities because the care provider and the person requesting help are on their way together to find out what offers support and the person requesting help feels that they are being taken seriously. The counselor tries to build up a feeling relationship, which leads to more understanding. This can reduce the tension between care provider and client and create a bond of trust. This often helps the person seeking help to overcome shame, fear, disappointment, pain and anger.
Filter
An important goal is then: striving for what is feasible and manageable. Filtering the experienced problems can then become easier. If the person asking for help feels accepted, the ‘decoding’ and ‘deciphering’ can begin and one can focus on the core of what is going on at that moment. Such an approach helps to process and integrate past experiences. These may be factors that have led to the unexplained physical complaints. Insight makes it possible to learn how to deal with the current situation (including traumas, inner experiences, difficulty adapting to changing circumstances). This benefits the quality of life, which leads to more self-confidence and self-awareness for people in this growing target group. Caregiver and client, but also the total mental health care system benefit from this.
Jo Vandermeulen is a clinical psychologist and clinical neuropsychologist and author of the recently published book ‘Complex problems, diagnosis and treatment’.