Avoiding Responses
There are certain responses that should be generally avoided when responding empathetically. (1) It is easy and commonplace to respond in these ways because it may seem natural, but it is important to recognize these responses and assess their appropriateness according to your specific situation.
Judging response
This response involves telling patients that they should not feel the way they are feeling, or that you agree with their feelings. An empathetic response should not agree or disagree with the patient’s opinion. Picking a side does not convey an understanding of their feelings.
Examples: “Don’t worry about it”, “You shouldn’t be concerned about this”
Advising response
We tend to want to do everything we can to help the patient but we need to keep in mind what our area of expertise is in, which are medications. In terms of providing solutions to emotional or personal problems that are not medication related, the best advice is often within the patient and they need to arrive to it themselves. Offering empathetic listening and responding can help patients arrive at their own decisions. If the patient is specifically looking for advice, then take it as an opportunity to identify sources of help such as community support groups or referral to a specialist, depending on the nature of the situation.
Reassuring response
A reassuring response may seem helpful but this type of response may change a patient’s feelings rather than accepting those feelings as they exist. Reassurance is also a method to protect ourselves from being emotionally involved with the patient. A study that surveyed chronic lymphocytic leukemia (CLL) patients on their satisfaction with their physicians found that for physicians using the reassuring phrases such as “CLL is the good leukemia” and “if you could pick what cancer to have, this is it”, their patients had lower quality of life and decreased physician satisfaction. (2) Although the physicians were trying to compare CLL to other types of cancer in attempt to reassure the patient, it resulted in invalidating the patient’s experience and losing focus on what the diagnosis meant to the patient.
Examples: “I’m sure everything will be ok”, “Things will work themselves out”
Generalizing response
Relating the patient’s experience to a similar one of your own may provide them comfort, but it may also take the focus away from the patient. It can also lead to jumping to your own conclusions about the patient’s feelings, even though they may not necessarily apply to your patient’s own situation. Similarly, if you say “everyone feels that way”, it makes the patient feel that you do not consider their feelings as unique or special.
Examples: “I know how you feel”, “This happened to me too”
Probing response
Asking questions when the patient has expressed a feeling can remove focus away from the feeling and onto the content of the message, which is undesirable if wanting to respond empathetically. The patient may also be expecting a solution if too many probing questions are asked when often there are no easy solutions to be had, resulting in disappointment for the patient. However, there may be situations were probing responses are appropriate to ensure you have adequate information to better understand the patient.
Distracting response
We may try to get out of situations we don’t know how to respond to by changing the subject.
Example: “Let’s talk about your new medications”
References
Judging response
This response involves telling patients that they should not feel the way they are feeling, or that you agree with their feelings. An empathetic response should not agree or disagree with the patient’s opinion. Picking a side does not convey an understanding of their feelings.
Examples: “Don’t worry about it”, “You shouldn’t be concerned about this”
Advising response
We tend to want to do everything we can to help the patient but we need to keep in mind what our area of expertise is in, which are medications. In terms of providing solutions to emotional or personal problems that are not medication related, the best advice is often within the patient and they need to arrive to it themselves. Offering empathetic listening and responding can help patients arrive at their own decisions. If the patient is specifically looking for advice, then take it as an opportunity to identify sources of help such as community support groups or referral to a specialist, depending on the nature of the situation.
Reassuring response
A reassuring response may seem helpful but this type of response may change a patient’s feelings rather than accepting those feelings as they exist. Reassurance is also a method to protect ourselves from being emotionally involved with the patient. A study that surveyed chronic lymphocytic leukemia (CLL) patients on their satisfaction with their physicians found that for physicians using the reassuring phrases such as “CLL is the good leukemia” and “if you could pick what cancer to have, this is it”, their patients had lower quality of life and decreased physician satisfaction. (2) Although the physicians were trying to compare CLL to other types of cancer in attempt to reassure the patient, it resulted in invalidating the patient’s experience and losing focus on what the diagnosis meant to the patient.
Examples: “I’m sure everything will be ok”, “Things will work themselves out”
Generalizing response
Relating the patient’s experience to a similar one of your own may provide them comfort, but it may also take the focus away from the patient. It can also lead to jumping to your own conclusions about the patient’s feelings, even though they may not necessarily apply to your patient’s own situation. Similarly, if you say “everyone feels that way”, it makes the patient feel that you do not consider their feelings as unique or special.
Examples: “I know how you feel”, “This happened to me too”
Probing response
Asking questions when the patient has expressed a feeling can remove focus away from the feeling and onto the content of the message, which is undesirable if wanting to respond empathetically. The patient may also be expecting a solution if too many probing questions are asked when often there are no easy solutions to be had, resulting in disappointment for the patient. However, there may be situations were probing responses are appropriate to ensure you have adequate information to better understand the patient.
Distracting response
We may try to get out of situations we don’t know how to respond to by changing the subject.
Example: “Let’s talk about your new medications”
References
- Tindall W, Beardsley R, Kimberlin C. Communication Skills in Pharmacy Practice. Baltimore, Maryland. Lippincott Williams & Wilkins; 1994.
- Shanafelt TD. The physician-patient relationship and quality of life: lessons from chronic lymphocytic leukemia. Leuk Res. 2009 Feb;33(2):263-70.