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Posted on September 24, 2015 at 9:55 AM
guest post by Christina Sisti

Doctors and nurses are becoming more accustomed to those who are seeking a confirmation of their home diagnosis but how do they know when a patient isn’t telling them everything? Every day we put on our game face or our poker face which minimizes our emotions. Our poker faces are costing us our health. Minimization reduces the chances of a proper diagnosis and the ability for a doctor to treat an illness. Minimization doesn’t begin in the doctor’s office though; it begins in society. For some, not telling or to downgrade a symptom is the socially acceptable thing to do amongst family and friends. Minimization may take three different forms when a person is facing pain, fear or illness: 1. Cognitive distortion 2) Understatements and 3) Social minimization. In each of these forms self-esteem/depression may also suffer from the effects of minimization. I believe minimization creates more harm than good for a person’s physical and emotional health.

Cognitive distortion occurs when the person or others avoid acknowledging and dealing with negative emotions by reducing the importance and the impact of actions which cause the emotions. Some may protect or try to divert attention/confrontation by reducing the negative impact of one’s actions upon another by minimizing the perception or feelings of the person who feels pain. By reducing the behavior and its impact it creates a false feeling of safety for one person while creating a feeling of betrayal or hurt for another. Once feelings, fears or pain has been reduced it is hard for the person who feels pain or fear to speak up and explain how they may feel because their feelings have been minimalized by another. To say anything otherwise would be awkward and place not only themselves in a position of being scrutinized but the minimizer in a defensive position. The risk of being viewed as a “drama queen/king” may not be worth the attempt to right the harm done by the minimization. Thus, a feeling of hurt, unwillingness to extend oneself and voice thoughts becomes suppressed.

Understatements are often rooted in cognitive distortion. They belittle another’s feelings by reducing the strength of someone’s feelings or thoughts. When one says tells another they “don’t feel that bad” or “a little bit” hurt/sick they reduce a person’s feelings about a situation which is occurring. It often times has the effect of a person not speaking out when they are in pain or when they notice symptoms which are troubling to them. By not speaking out the person may not alert their doctor in time for an early diagnosis and treatment. Brushing thoughts, feelings and fears under the proverbial rug may cause a greater pain.

The root of understatements and cognitive distortion lies in social minimization. In society we ask others how they are but never expect an honest answer. We don’t want to hear what is really going on nor do we want to be placed in a position of being asked to help or accepting responsibility for how our actions affect others. Some may argue this is not true but I point to the “poker face” and interchanges in which the “victim” minimizes the effects of actions by brushing them off or using reduction words such as “a bit”, “a little” or “merely.” Society has rules on how we display our emotions, how we talk to each other and how we express our pain. There is a general consensus we must present a strong front and “suck it up” for fear of being viewed as weak or as a hypochondriac.

This need to minimize is insidious. It disallows for expression, reduces self-esteem, increases depression and allows others to manipulate our feelings. I am afraid of going to the doctor despite knowing things are not exactly as they should be. I question how to respond to others once another has minimalized my feelings, I question my own feelings based upon another’s reduction of said feelings. I wonder if I tell how I really feel, seek answers and express my thoughts if I will be viewed as too needy or as an attention seeker. Funny thing is, by not taking action I hold in my pain and fear and only hurt myself. What would happen if we expressed our thoughts, fears and pain in a healthy manner? Could we reduce the rate of depression or increase feelings of self-esteem? More importantly, would the rate of detection for disease and illness increase while morbidity decreased? Could we increase society’s health by decreasing minimization?

Minimization needs to be contained. Before a word is spoken or the attempt to downplay another’s actions or feelings takes over your response: stop and think of your actions and the effects they have on all parties. Conversation, healthy, constructive conversation, may begin a path which leads to increased mental and physical health. Society gains from productive, healthy conversations which seek to uncover fears, decrease pain and examine pain.

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Christina holds a Doctorate of Professional Studies from Albany Medical College’s Alden March Bioethics Institute with a focus on Health Policy and Ethics.

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