23: Interviewing Pts with Emotional Difficulties - Streyffeler

Question 1

acute emotional stress –>

Answer 1

• can be contagious and distress the provider
• can make an exam and interview more difficult
• can impair concentration and memory, making it more difficult for the pt to provide an accurate history and to remember the provider’s instructions

Question 2

how does a history of trauma or having been hurt color medical encounters?

Answer 2

• provider will often be seen as threatening or frightening figure
• may be highly sensitive to pain, often does better with the provider giving control to the pt as much as possible

Question 3

how does a history of depression color medical encounters?

Answer 3

• may impair ability to follow a treatment plan

- may impair ability to have hope that things can improve

Question 4

how does a history of anxiety color medical encounters?

Answer 4

• can manifest as extreme sensitivity to and fear about medical symptoms
• in obsessive anxiety, pts can need to tell their stories and recount symptoms in excessive detail

Question 5

how does a history of psychosis color medical encounters?

Answer 5

• very frightening for pt (can also be for provider)
• hard for pt to concentrate and make sense of what is going on
• hard for the provider to ascertain a logical sequence of what is happening for the pt

Question 6

areas to listen for in interview:

Answer 6

• symptoms and signs of biological illness
• social or interpersonal problems, including acute crises and chronic stressors
• psychological problems, such as repeated styles of interpesonal interaction that impair functioning
• all three domains relate toa pts emotional status, and all three need to be addressed for full functionin g

Question 7

= state of distress where the self is felt to be somehow not good, inadequate or defective. self is felt to have some deficiency and the typical response is to wish to disappear

Answer 7

shame

Question 8

= temporary status of the self that is felt to be lowering or debasing, generally caused by someone else

Answer 8

humiliation

Question 9

= state of distress caused by the commission of a forbidden or immoral act, and the typical response is a desire to make amends

Answer 9

guilt

Question 10

in order to avoid shame, ppl need to feel:

Answer 10

• loved rather than rejected
• strong rather than weak
• successful rather than a failure
• clean rather than contaminated
• good rather than bad
• whole physically and mentally rather than defective
• in control of body and mind rather than the body and mind exhibiting out of control symptoms or behaviors