Managing Emotionally Charged Patients: The Power of Labels in Physiotherapy

As a physiotherapist managing a highly emotional patient, it’s important to understand that humans are naturally inclined to think negatively, especially if they are upset for any reason. Research conducted by the National Science Foundation in 2012 revealed that up to 80 percent of our thoughts tend to be negative, and a significant portion of the brain’s amygdala is dedicated to processing negative emotions. So imagine what happens when the person you’re talking to is feeling angry, frustrated or over-whelmed.

This knowledge is crucial because negative emotions can hinder clear thinking and effective communication. As a physiotherapist, it is essential to address and manage these emotions to facilitate constructive dialogue and positive outcomes for you and your patients.

Unfortunately I learnt this the hard way early in my career when seeing a patient who was clearly angry about something. I went straight into the history taking and management ignoring his emotional state because I didn’t know how to handle his anger.  We had no rapport and I never found out what he was angry about as he didn’t come back in for further treatment even though I had helped him with his knee problem.

Fortunately, there is a simple approach that can help you de-escalate strong emotions and it is one that I wished I’d known about all those years ago. By using a technique in motivational interviewing called ‘labelling’, you can identify and defuse the negative emotions that your patient may be experiencing, paving the way for a more informative history taking and a treatment plan that benefits both parties.

How Labelling Help Defuse Negative Emotions

Negative emotions tend to persist if left unaddressed. By using the labelling technique with genuine curiosity, you can bring your patient’s negative sentiments to the surface, even if they are not immediately apparent. This process can help your patient think more clearly and uncover potential solutions that may have been obscured by their negative mindset.

Many people shy away from discussing negative emotions during difficult conversations, just like I did. However, by directly acknowledging and confronting these emotions, you can distinguish yourself as a different kind of clinician. Your patient will see you as someone who is willing to tackle challenging conversations head-on, fostering a sense of trust, respect and facilitating the development of empathy.

Neutralising Negative Emotions with the Labelling Process

When interacting with a patient who is clearly upset about something, make it a priority to focus on their needs and listen carefully. If you’re listening and waiting for your time to talk, you will miss valuable information.

Approximately 75 percent of your conversation should revolve around your patient, creating an environment where they feel truly heard and understood.

Often anger, frustration and overwhelm are side products of being under a lot of pressure. Everyone experiences pressure, yet it is often overlooked in conversations. You have no idea what is causing negative emotions until you label something and it doesn’t matter if you get the label wrong.

You could say, “It seems like you’re under a great deal of pressure.”

This simple statement can go a long way in making a patient who is struggling, feel valued and validated.

By recognising a potential for pressure to be the cause of an outburst, you allow the patient to agree with you or tell you what’s really behind their emotional state. Either way, you’re going to find out valuable information.

As negative emotions de-escalate, your patient becomes significantly more likely to listen to you and collaborate with you. After all, people prefer working with individuals they like and trust.

The Importance of Using Labels Correctly

Labels are intended to be verbal observations of unspoken thoughts or feelings. However, if used carelessly, they can come across as personal attacks, exacerbating negative emotions instead of defusing them.

For instance, if you believe a patient is not engaged in the treatment process and say: “It seems like you’re no longer concerned about getting better,” it may be perceived as an attack or frustration on your part.

To address this issue tactfully, consider rephrasing the label: “It seems like balancing what you need to do to improve and your home/work commitments is a struggle for you at the moment.”

This statements addresses the same concern while allowing for a more considerate approach to open communication.

Remember, unaddressed negative emotions have a tendency to resurface even after reaching an agreement, potentially hindering treatment progress. Or at worse, your patient may not come back in to see you. By using labels to confront these emotions directly, you can cultivate better patient relationships and achieve more successful treatment outcomes. It’s a win-win situation.

For more information on ‘Labels’ have a read of “Labels vs Questions When Engaged in Challenging Converstations”

Where to from here for Thinking.Physio?

Skills practice and reflection are the cornerstone of my training. I am available for both in person and limited Zoom PD for your group.

If you have a staff member who is struggles keeping new patients or confidently presenting treatment plans, you might be interested in one-on-one coaching for him/her. I take on a limited number of clients each year.

If you would like to engage me to work with your staff or coach a member of your team, click here so that you can schedule a time to discuss your specific training needs.

Contact me to find out when I will be in your city and available for LIVE professional development.

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