This Line Should Be Banned From Healthcare
“It is all in your head”.
I’ve heard this phrase or some version of it on several occasions. I’ve heard it on the job as a healthcare provider and as a patient too. When all tests are done and results are in, showing no apparent “physical” problem, providers exhale relief while patients leave even more confused and scared.
I get it. Healthcare providers have it rough. As a registered nurse, and later a nurse practitioner, I’ve experienced the relief gained from seeing a list of fairly normal test results, especially on a hectic, physically exhausting, and emotionally draining workday. We are there to find the cause of yet another problem and fix it. But if there is no problem at all, the faster the workday will go. Except this person’s problem won’t go away just because the visible, tangible tests are normal. On the contrary. The problem now has become an unknown force. This person just went from “I have this or that problem” to “there is something wrong with me”. Both might sound about the same, but the impact of the latter on a person’s wellbeing is much greater.
We are a complex web of flesh and bones, organ systems, thoughts, feelings, and emotions. And more than half the time we go about our lives without paying much attention to the things that matter. We worry about our position in the world compared to others. We worry too much about past hurts and future pains. And we do all of this worrying with our “heads”. But what happens when this misplaced attention materializes in our physical world? We wake up in the middle of the night with a pounding heart. We suddenly feel dizzy or faint, choked up with fear, unable to move. Every waking hour becomes a struggle to feel normal, even if everything else in our lives appears to be going just fine. Life becomes a battlefield, where the war seems already lost no matter how hard we fight. It is as real as it sounds cliche.
As a patient, I’ve been told some version of the “it is all in your head” line. And it only led me to feel more isolated and lost. Why is it such a wrong thing to say?
First, the obvious. It is far from delivering the help that a healthcare provider is there to offer. It is true anxiety and its (very real) physical effects stem from the brain, but that is exactly why it is such a difficult problem for a sufferer to deal with. If it were as easy as putting a bandaid on a scratch (as it is often implied by such a remark) we wouldn’t be seeking help at all.
Second, it is packed with judgment, the last thing a person with anxiety (or any other problem of the mind) needs to encounter. It completely disregards the complex and diverse situations or backgrounds that might lead a person to such states. It ridicules the most common yet life-altering ailments humans have suffered from since the beginning of time. Because let’s face it, the number of us walking out there without battling some kind of mental or emotional burden is very limited.
Being told things like this not only had me sink even further as an anxiety sufferer, but it also broke my nurse’s heart. It went as far as to make me feel disappointed in the healthcare profession. Eventually I gained my passion back. And in the process, I also gained an insight that maybe I wouldn’t have if I wasn’t both a healthcare provider and an anxiety sufferer.
Historically our relationship with matters of the mind has been a messed up one. We are quick to celebrate the human mind as that which makes us stand superior in the animal kingdom, yet we turn lazy and judgemental when faced with its imperfections. We have come to accept this behavior and leave it unchallenged. We have come to believe that only mental health specialists should concern themselves with such matters. But because of the tremendous impact of all healthcare professionals’ words and actions on patients’ wellbeing and lives, we shouldn’t compromise when it comes to this specific phrase or any version of it. We should ban it from our vocabulary, and saying it should be regarded as damaging an action as ordering the wrong medication or operating on the wrong limb.
Healthcare professionals are human too. As such we will inevitably make mistakes. Causing hurt is an inherent risk of helping and healing others. Yet over the years we have made great improvements to reduce such risk.
Let us really include the mind as a part of us that also needs protection from such risk.
