Dear Therapist:

I am currently involved in a medical crisis (I was diagnosed with an illness, but we are not sure how serious it is yet). I need to get a lot of opinions from doctors and make choices regarding my treatment. I have never really been an assertive person but now I am really lost. Everyone has an opinion, I have no idea what to do and the doctors are talking over my head. It seems that if I don’t push I don’t get answered but if I do they get annoyed at me. Asking friends and family for help just makes it worse because then I get a hundred more ideas. I feel completely alone and overwhelmed. Please give me some advice as to how to be strong enough to manage this. If you have any tricks or techniques as to how to be more confident and assertive I would really appreciate it.

Response:

My heart goes out to you in this difficult situation. Dealing with the medical establishment can be overwhelming. This is especially so when you’re emotionally involved. You say that you feel alone. This is ironic because you have so many people ostensibly trying to help. Unfortunately, this is a common occurrence when people are faced with an illness or another type of personal crisis. Although you can intellectually recognize that your friends and family are trying to be helpful, you are the only one in the center of the issue. You’re the one who sees and feels it from the inside—and the one who ultimately needs to make the tough decisions.

It may be easy for others to casually make decisions. They’re not the ones who need to deal with the agony of considering an unclear diagnosis. They won’t be continually weighing multiple treatment options, then second-guessing their decisions. They won’t need to face the consequences of these decisions. Many of them have the luxury of hearing only a small part of the story (like one doctor’s opinion, or a couple of treatment options), and relatively unemotionally making a decision without looking back.

I don’t know whether the level of severity of your illness will in any way dictate treatment options. At the time that you wrote in, the severity level was in question. Hopefully, at this point you have a more definitive understanding of the seriousness of your illness. Hopefully, it is mild with a clear and straightforward course of treatment. Regardless, clear recognition of what you’re dealing with can make it a little easier to come to a decision. The more ambiguity that exists, the more control your unconscious mind exerts. This leads to more emotion and increased difficulty in decision-making.

We all react with a combination of logic and emotion in just about every situation. Ideally, important decisions should be decided largely based on logic. When a situation arises that causes us to feel very strongly, it can be difficult to set our emotions aside in order to analyze things logically. Any lack of clarity within a situation typically adds to the emotional side, making it more difficult to focus on the situation from a logical perspective.

The doctors who get annoyed at you likely don’t properly recognize the emotional agony with which you’re dealing on a regular basis. They probably see your situation as black-and-white from a completely intellectual viewpoint. It may not be important for them to understand why it is so difficult for you to see things unemotionally. What’s more important is for you to recognize that this is perfectly normal, and that no one—especially someone who doesn’t understand—has the right to tell you how to feel or how to deal with your illness.

You’re the one who needs to work through your emotions. Part of this process is getting as clear and unambiguous an understanding of your diagnosis as you require. If there’s anyone (doctor or otherwise) who doesn’t get this, that’s their problem—not yours. Your responsibility to yourself is not only to identify the best treatment option; it’s also to deal with the emotional roller coaster that your diagnosis has triggered.

Whenever you feel intimidated by doctors, remind yourself that their job is easy; they need only dispassionately deliver a diagnosis and treatment. They don’t need to grapple with all the fears and trepidations associated with the entirety of your situation. Remember that it is not only your right, but your responsibility to obtain answers to all of your questions.

Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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