Expired CME Article

Difficult Conversations: Anger in the Clinician-Patient/Family Relationship

Authors: Beth A. Lown, MD

Abstract

Anger is a “syndrome” of thoughts, feelings and physiologic reactions. Behavioral responses to anger are influenced by multiple contextual factors. Patients and family members may express anger in response to their own experiences of illness, the healthcare system, or the physician-patient/family relationship. Anger may evoke a variety of clinician responses that while understandable, inadvertently escalate patient and family anger. Clinicians who cultivate personal awareness, practice mindful self-monitoring during their interactions, explore the differential diagnosis of anger, demonstrate specific communication skills, set clear boundaries and seek personal support can overcome the challenges of these difficult conversations, and begin to restore trust in the physician-patient/family relationship.


Key Points


* Anger is a “syndrome” of feelings, thoughts, and physiologic reactions.


* One's response to anger depends on how one makes sense of, and copes with a stressor within a specific context.


* Patients and their loved ones may become angry in response to a sense of vulnerability, diminished sense of self, or disempowerment.


* It's best to address anger before it escalates.


* Clinicians can respond more effectively to patient and family anger by exploring its differential diagnosis, fostering self-awareness and the capacity to adjust one's own reactions, using specific communication skills, setting clear boundaries, and seeking support.

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