Category: Science & Tech

To get information from someone and get them to open up to you, you need only two things:

Is he wrong? \r\rTwo of the most important things I learned during my third year were “Tell me more” and “[awkward silence]”.\r\r“Tell me more,” works for every situation. Part of the problem with psychotherapy is that you’re always expected to have something to say. As a last resort, that thing is “Tell me more”. It sounds like you’re interested. It sounds like you care. And if you’re very lucky, maybe the patient will actually tell you something more, as opposed to their usual plan to stonewall you and hide all possibly useful information.\r\rI saw something on Tumblr the other day which, despite being about a 9-1-1 operator, perfectly sums up being a doctor too:\rmy bf has many interesting stories and observations from his new job as a 911 operator\rmy favorite is how meandering people are, even in the midst of a terrible emergency\r\rthey respond to “what is the emergency” with “well, the thing is, four weeks ago–”\r\rand then he’s like “WHAT IS THE EMERGENCY RIGHT NOW”\r\rand they’re like “so what happened this morning was, i said to my wife, i said–”\r\r“WHAT IS CURRENTLY HAPPENING AT THIS MOMENT”\r\r“oh i’m having a heart attack”\r\rAnd:\rmy second favorite is how specific he has to get sometimes\rlike, “what is your emergency?”\r\r“i’m sitting in a pool of blood.”\r\r“… is it… your blood?”\r\r“yes i think so”\r\r“do you know where it’s coming from?”\r\r“probably the stab wound”\r\r“have you been stabbed?”\r\r“oh yah definitely”\r\rPsychiatry is like this, except it’s all very vague, and your patients are really suggestable, and people are always afraid that if you just ask specific questions like “Are you depressed?” then they’ll say yes to make you happy and won’t talk about how the real problem is their anxiety or something. So instead, the patient says something like “I’m sitting in a pool of blood”, and I say “Tell me more…”. They say “Well, it’s my blood.” I say “Tell me more…”. After repeating this process a couple of times, we finally get to the stabbing, and the patient doesn’t feel like I railroaded over their chance to tell their story.\r\rOr it helps you figure out what’s important to the patient. If someone said “I hate my husband so much,” my natural instinct might be to ask “Why?”. But maybe why isn’t the question the patient cares about. Maybe what she really wants to talk about is how guilty she feels about hating their husband, and if I asked her why then we’d get on a tangent about what the husband is doing that never addresses her real problem. Maybe she’s agonizing every moment about whether or not to divorce him, and losing sleep over it, and coming to me for a sleeping pill. Maybe she’s just hatched a plan to kill him and wants to check it over with me to see if I can find any flaws. In any case I should probably figure out why they hate him eventually, but if their real issue is whether or not I approve of their murder plot then we should probably get to that first.\r\rSo instead, it’s “I hate my husband so much.” “Tell me more.”\r\r“I’m feeling depressed.” “Tell me more.”\r\r“Sometimes I think life isn’t worth living.” “Tell me more.”\r\r“Listen, if you don’t give me a prescription for Adderall right now I swear to God that I will stab you right here in this office!” “Tell me more.”\r\rThis has seeped into my personal life. I was on a date with a girl earlier this year, and whenever she started telling me about her life I would just say “Tell me more”, and it worked.\r\rAnd then there’s [awkward silence]. I learned this one from the psychoanalysts. Nobody likes an awkward silence. If a patient tells you something, and you are awkwardly silent, then the patient will rush to fill the awkward silence with whatever they can think of, which will probably be whatever they were holding back the first time they started talking. You won’t believe how well this one works until you try it. Just stay silent long enough, and the other person will tell you everything. It’s better than waterboarding.\r\rThe only problem is when two psychiatrists meet. One of my attendings tried to [awkward silence] me at the same time I was trying to [awkward silence] him, and we ended up just staring at each other for five minutes until finally I broke down laughing.\r\r“I see you find something funny,” he said. “Tell me more.”\r\rhttp://slatestarcodex.com/\r\r\r

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