How Bedside Manner Can Contribute to Anxiety and Shame

How doctors treat us can have a significant impact on how we feel about seeking medical care and how anxious or frightened we are in clinical settings. While many doctors are compassionate and understanding, those who lack these qualities often leave us feeling invalidated, frightened, and shameful. Clinical invalidation can leave a lasting impact on our psyche and affect our willingness to seek appropriate medical care. We may become avoidant, panicked, or distrustful of doctors, and this can result in ongoing medical trauma. It is incumbent upon our medical providers to understand the important intersection between the physical and the emotional and on us to understand that we have the right to feel validated by our providers.

The two instances below really happened to me at a time when I was experiencing severe anxiety and panic attacks. I was unaware that panic and anxiety could cause my body to respond in such a frightening way, and I needed reassurance, education, and validation. One doctor offered me this, and one did not, and to lift a phrase from Robert Frost that has made all the difference.

Doctor 1

As a 27-year-old at a cardiologist’s office, I was probably not his usual type of patient. But I was there on a referral from a general practitioner after complaining of heart palpitations and chest tightness. More than a decade later, I know now that I had been experiencing panic, not any sort of cardiac problem. But I feared that something was terribly wrong with my heart.

The cardiologist, however, seemed frustrated that I was there, brusquely reprimanding me, “I can’t tell you what every little thing you feel in your chest is.” He brushed off my concerns, offered no empathy, and sent me home without any answers.

I felt ashamed that I had even gone there, that I had wasted his valuable time, and that I was just being silly for being concerned about my health. I was more anxious than I had been before I had arrived. This doctor never once mentioned the possibility that I might be experiencing anxiety, though it is well-documented that we commonly feel anxiety and panic in the cardiac system.

Doctor 2

With tears in my eyes, I told the doctor that I felt “messed up.” I was struggling to describe my symptoms, frustrated by how overwhelming they had become, and nervous that he might think I was just being ridiculous. The doctor listened attentively, then pulled his chair up beside me and gently reassured me, saying, “We’re going to do everything we can to check you out and make sure nothing’s going on, but I think what you’re experiencing is anxiety.”

He spoke to me compassionately, nonjudgmentally, and with full validation of my concerns. The way he communicated with me never caused me to feel irrational, shameful, or silly. I felt cared for, listened to, and understood. Most importantly, I felt that he had my best interests in mind and that he was committed to helping me sort out what was bothering me. Doctor 1, on the other hand, had seemed annoyed with me and had never attempted to reassure or comfort me.

Almost 20 years later, I recognize the impact of Doctor 2’s empathetic response and the invalidation of Doctor 1’s. From each, I learned something about my rights as a patient:

• I have the right to feel listened to and understood by my medical provider.
• I have the right to seek a second opinion if I am dissatisfied with my provider’s bedside manner.
• I have the right to ask as many questions as I need to in order to understand my diagnosis and treatment.
• I have the right to feel that my provider is upholding their oath to “do no harm,” which includes psychological and emotional harm.

Your medical treatment goes beyond the purely physical. As you advocate for yourself, keep these rights in mind. Your medical provider has a duty to care for your emotional health every bit as much as they care for your physical health. Because our physical well-being can be a natural source of anxiety, expecting validation and comfort from our caregivers is not only acceptable but also necessary.