A spoken monologue advising counselors (and others) how to support people experiencing acute physical pain. Emphasizes reading the patient’s preference for overt empathy versus stoicism, offering sincere, action-focused empathy (e.g., 'I wish I could make it easier for you') rather than morbid sympathy, and considering practical advocacy (family support, contacting physicians, arranging advocates) when appropriate to the therapeutic relationship.
What about their dealing with a physical pain in a given moment? Whenever there's physical pain, you get a feel after being with somebody as to whether they really want you to be so supportive and empathic with the pain or whether they want to ignore it. There are certain people that really want to be more stoic, and they actually really don't want you to even be empathic overtly. And certainly it's a very important distinction at that time not to be too, let's say, overly sympathetic where you're going, oh, I'm so sorry that you have that pain versus some reaction, like, I wish I could make it easier for you, where you're really showing true empathy rather than a sense of morbidity. And there are very few patients that really like morbidity. And almost every patient likes to feel empathic, like, you wish you could help them. If there was anything you could do, you would do it. And then you're asking sometimes, maybe, is there any way that I can possibly be a support to you? I know at the same time, while I'm asking you this, of course I can't be of the greatest support that you would want, which is to take it all away, but is there anything else that I could support within that context as their counselor? They're coming to me. Can I call their physician? Should I be asking, if you're not getting what you need in that way, Would you like my support in that way? Is that crossing a line? It depends on the relationship you have with the client. If the client really has one that you've probably had for years, and they very likely have asked for your support, you could do that, but it probably would not be something that you would initiate. What you may more likely initiate is, do you have the appropriate family support? Do you have advocates that are really there for you? And then out of that conversation, they might say, no, I don't, but I wish I did, then it might be okay to say, is there any way that you would want me to advocate for you? But I think that you're bringing up a very important point there where it's so critical that the patient has a team of advocates. Because in our world today, in the hospitals with doctors, everyone is human. And so when somebody's really looking out for your life and they're totally invested in you, that's very different than a staff member who has 50 patients or 100 patients or 500 patients. And so it is our responsibility as counselors to advocate for each patient, to have advocates.
