When Doctors Are Insensitive to Mental Illness
“I noticed you have complex PTSD (CPTSD) in your file. Have you ever had any sexual trauma?”
“No, no. Nothing like that,” I quickly answered, trying to hide the shock I felt by such a blatant question.
“Well, I’m only asking because pain during sex can be attributed to abuse,” continued my doctor.
This question was not posed during a therapy session, a psychiatric visit or a GYN exam — all of which would have been more appropriate environments to raise the delicate subject of trauma.
I was sitting in the office of my allergist. Her assistant coolly typed session notes on a laptop as this exchange took place. My doctor resumed our discussion, which involved testing for a possible latex allergy. I was stunned.
This test had been recommended by my GYN due to discomfort and irritation during intercourse while using a condom. I experience environmental and chemical allergies, receive monthly immunotherapy shots and take daily antihistamines; not a stretch that latex could be the culprit.
In her attempt to rule out other possibilities, my doctor meretriciously posed a question with little regard for the sensitivity of the matter.
The impact of this commentary did not hit me right away. My quick response had been a defense mechanism to hide discomfort and move on from the topic.
Later, I repeated the encounter to my therapist. She exclaimed how inappropriate my allergist had been in asking such a personal question in, quite frankly, the wrong environment.
So, have I had sexual trauma? No.
But what if I had?
What if my CPTSD diagnosis was, in fact, due to rape, abuse, or molestation?
My doctor had fired off a remark with little tact or consideration regarding privacy, emotional safety or her own qualification to enter the territory of trauma or mental health.
This was certainly not the first time I had encountered such disregard for emotional well-being.
During an annual gynecological exam, the doctor commented on my low BMI. She alluded I had an eating disorder.
I explained my clinical diagnosis of CPTSD, accompanied by severe anxiety and depression. I had left work, I was in therapy, I was trying medication and under the care of a psychiatrist.
My primary care doctor had referred me to a nutritionist. Vitamin levels were checked and blood work assessed to ensure an eating disorder or other medical problems were not at play.
I received a thumbs up for good diet, healthy eating habits and normal labs.
The doctors concluded that my brain remained in constant “fight or flight” mode; this made for exceedingly high calorie burn. It was a struggle to eat more and more in order to maintain a healthy weight, especially with acid reflux compounding the issue. Pounds were being worried away with no direct intent on my part.
CPTSD was the diagnosis; the result of childhood physical, verbal and emotional abuse from living in a home embroiled with extreme turmoil, stemming from the inadequacies and poor mental health of my parents.
The disbelieving eyes of my gynecologist looked me up and down while I recounted this information.
“You have to watch out for the anorexia,” she responded, turning her back to me as she removed exam gloves and washed her hands. “It’s math. Calories in, calories out.”
Do I have an eating disorder? No.
I realized this doctor had little to no understanding about mental illness. She saw a symptom, jumped to a conclusion and looked no further.
I immediately left her care and began to see another, more sensitive, gynecologist; the one who subsequently referred me for latex allergy testing. She assured me not to worry. Once my anxiety became more manageable, the weight would come back on.
But, again, what if I did have anorexia or bulimia or purging disorder or avoidant food intake? Some terse words and a warning to “watch out for the anorexia,” were by no means helpful, supportive or an invitation for help. It was like saying, “You have to watch out for the cancer.”
Dismissive, reproachful statements can make patients feel defective and less likely to seek help for a disease or illness they did not cause or ask for.
If a doctor truly thinks a patient has a serious medical condition, I assume the mere warning or pointing out of said condition does not fall under the protocol of good medical treatment.
It’s shocking that healthcare “professionals” are so unskilled and uneducated when it comes to mental illness. They question the authenticity of your words. Your ailments are suspicious. Their delivery of so-called “advice” is less than considerate.
If it’s not their area of specialty, why don’t they proceed with caution? Why do they jump to conclusions instead of listening?
What if everything I relayed to my allergist and GYN was not true? What if I was raped or had an eating disorder? How do they think a few careless words could offer me the help I would desperately have needed?
Would any of these exchanges at a doctor’s office help the victims of sexual abuse or those who struggle with an eating disorder? Assuredly, no.
To be listened to, to be heard, to be treated with respect and understanding — these are things a person with mental illness does need, whatever the root cause.
Managing mental illness is difficult and challenging. Being treated like it’s no big deal by insensitive doctors touting callous comments can make the road to recovery harder to navigate.
Conceivably, the constant flow of patients and daily health assessments create a hardened immunity among healthcare professionals. People are no longer people, but problems; a file folder of symptoms where “human being with feelings” has dropped off the chart.
It’s time for patients to take back their identity. It’s time to speak up and remind our healthcare providers that bed-side manner and respect is not optional but compulsory.
Fortunately, I have a brilliant therapist, a skilled psychiatrist and a network of supportive physicians who continuously help me navigate the complexities of mental health. I remain focused on the excellent care I do receive and leave the inappropriate interactions and subsequent bad feelings behind; they don’t serve me.
I am thankful for every provider in the medical field who practices because they care and their calling to heal is a sacred undertaking.
If you are a doctor, nurse, or health practitioner, I hope my words have served as a reminder that every patient deserves respect. Every patient deserves kindness. Every patient deserves help and care and if you don’t know what to do, follow the Hippocratic oath and refer them to someone who does; don’t pass judgment or fling thoughtless, dismissive words at people struggling.
As the grade school saying goes, “Think before you speak.” There are human sensitivities behind every lab result, every symptom and every illness.
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Getty image via andrei_r