I’ll meet you there.
Rumi (13th Century Poet)
Anger is one of the emotions that triggers all kinds of responses from loud shouting, to shutting down, to tears. And that’s not just the patient. It could be a family member or a colleague. It could be you.
It certainly has been me.
What I’ve learned over the years of working with angry patients, their anger usually builds up from a number of smaller frustrations until, there is one frustration that causes a breaking point.
Nurses and physicians say to me, “I don’t get it? Everything seemed fine and then, wham! They (patient or family) were seething and listing off a whole host of things that’d been ‘going wrong.'”
That’s right. That’s often how it happens. Because everything is fine. Until it’s not.
It’s not always easy for someone to know when they are nearing their breaking point. They just break.
If you’re the one nearby, or the “cause” of that final straw, you will most likely get an earful. And you can think, “Whoa! What just happened to cause this?”
In my role as Patient Advocate, I listen to people’s frustrations and anger. While I know people can exaggerate when they are angry and that the view of the situation is narrowed (the fight response), it’s not the moment to try to correct their perceptions.
The last thing you want to set up is an “us versus them” emotional environment. I find the best response in the moment is to open up my heart and disarm myself.
Here are the 5 Things You Can Do When Your Patient is Angry
One: Connect with Your Body
Sudden anger can catapult you right out of your body. Your body is still there, but your mind disappears. Where has it gone? Either to past experiences (like childhood) of shouting/anger or, to the future; mentally designing verbal or physical escape routes. This leaves you unprepared to work with the present situation you are facing.
Instead, connect with your body through your breath. Feel your breath expand your chest and belly on the in-breath and soften your belly and chest on the out-breath.
Think and Breathe: In-Spaciousness. Out-Soften, to stay present. Mind and Body together.
Two: Remember Your Intention
When a patient (or family member) is angry, s/he is usually not interested in hearing, “I or they didn’t mean it.” Or, “I can hardly believe that happened!” Even if you can’t.
Anger often arises because some level of trust or expectation has been broken. Your first goal isn’t to be right or even to admit wrong (unless you should), it’s to regain the person’s trust and the relationship. Even if the trust broken wasn’t with you personally.
Stay with your intention which is to regain and reestablish a trusting relationship.
Three: Awareness of Posture: Inner and Outer
Most people when they are confronted with anger, want to buffer themselves against the force of energy directed at them. It’s part of our naturally inherited fight, flight or freeze response.
But, as I learned long ago in my studies and practice of mindfulness, you actually have more stability in a confrontation if you have flexibility. Let your breath not only soften your thoughts, but your body posture.
In the moment of anger, we want to be stable, not rigid. Rigidity (mental and physical) leads to stuck-ness and usually more anger. Not the cycle you are going for.
Let yourself remember as you breathe, this is someone who is suffering (because they are). And you are there to help (because you are).
It takes your own resolve to resist the arising urges (and they will arise, over and over again) to tell them why they shouldn’t be angry.
Four: Ask, “Tell me more”
Ok, the last thing most people want to say to someone who is shouting at them is “Tell me more.” But trust me, the quickest way to defuse someone’s heated moment, is through uninterrupted listening. With a receptive inner and outer posture and your non-confrontational invitation, they will know they are being heard.
This is the first potential pivot-point in the conversation. A pivot-point in a conversation that’s at odds, is the turning toward understanding and connection. It doesn’t mean you have the same viewpoint, but you can see with more clarity, their viewpoint.
At the pivot-point, you can notice that they are slowing down, quieting their tone and quite possibly even apologizing for their outburst.
Still, don’t interrupt or start talking. Their remorse or embarrassment is not an invitation for you to go into an explanation of the “why that might have happened”. Let the moment, have a moment.
Then your next words might be….
“Thank you so much for telling me this. I had no idea. Can you tell me more?
Or “Do I understand you correctly that you are feeling ____________,” paraphrasing what you understood. They’ll correct you if you don’t have it right and feel great relief, even if you don’t.
Five: Say “I’m Sorry”
The apology at this moment, is not about the possible “wrong-doing”. You are apologizing for their experience of feeling “wronged”. It’s important to hear them out before apologizing. Otherwise, you and they won’t know what you are sorry for.
Here are some phrases you can use:
“I’m so sorry. This is clearly very upsetting and I want to help.”
“I’m so sorry. What you described shouldn’t have happened. Let me or my supervisor look into that for you.”
Using words like “what you described” you acknowledge their experience. It’s not about who is right and who is wrong. You are offering your understanding of how they experienced the event(s).
Most often, just hearing the apology with your intention to help resolve it, will take care of the situation. If it’s a bigger deal, then it might need a bigger review by your Quality Team.
Some people worry that an apology is an admission of guilt. In the suit-happy world we live in, it’s easy to assume this. But the point of an apology is to begin the healing of a trust that was broken. It’s to open the way to true dialogue and a review of what happened, so we can provide the caring and safe care they deserve and we intend.
What’s been your experience? I’d love for you to share what you do when someone is angry. Enter your thoughts in the reply box below.
And if you want to learn mindfulness practices to help you in moments like these, learn about my Room to Breathe e-course below.
Until next time, be well!
Love,
Jackie
Room to Breathe: Rewiring for Ease
If you want more ways to work with the stress, chaos and the natural ups and downs in our complex health care world, join me and many others in the next Room to Breathe course. Learning mindfulness practices can make a big difference in supporting you to have successful communications with patients and staff and be happy in your work.
It also helps with your home life. Just saying.