Blaming others for their health problems helps no one

I inherited motion sickness from my father’s side of the family.  I can’t sit in the back seat of a car for more than 10 minutes without becoming sick.  I take meclizine before every plane flight.

I inherited asthma from my mother’s side of the family.  Exposure to perfume, 90+ degree temps with 90+% humidity, or even a good laugh will all prompt me to cough.

These two maladies of mine have one thing in common – multiple people over the years have informed me that they’re “all in my head.”

Among the advice I’ve received:

“You just need to distract yourself.”

“It’s all stress.  You need to relax.”

“Yoga. Yoga will realign your energies.”

“You’re taking too much medication.  Your body is reliant on it.”

Upon hearing these statements, I rapidly cycle through the following emotions: hurt, indignation, disappointment, anger.  None of those emotions provide a good starting point for hearing this advice, which I have to admit is probably well-intended.

But, if I am honest with myself, I can’t pretend that I am not guilty of thinking some of the same things about my patients.  I get frustrated that my overweight patients continue to choose unhealthy foods and avoid exercise.  I bite my tongue when my patient with liver damage continues to drink alcohol.  Maybe blaming others makes us feel better about ourselves, and it might even make us feel that we’re invulnerable to the disease under discussion; we’re making the “right” choices, after all, and that somehow makes us superior to the afflicted person.  I am certainly guilty of those same thought processes.

When I catch myself thinking this way, I try to override these thoughts with the knowledge I gained through my studies in health behavior theory (HBT).  The basic tenet of HBT is that each individual believes that the health choices he/she makes are rational and reasonable.  These choices are usually based on 1) the priorities their environment imposes on them and 2) their beliefs about health.  For example, if a person grows up in a poor neighborhood where most people are overweight and with limited access to healthy food, this person will likely deduce that being overweight and eating fast food everyday are normative conditions.

HBT teaches that blaming others for their health problems helps no one.  Whether it’s motion sickness, asthma, mental illness, fibromyalgia, obesity, diabetes — most 21st century health conditions are due to some combination of genetics, environment, and personal choice.  Health is a combination of personal responsibility along with the luck of the genetics and environment we’re born into.

Maybe if we could spend less time on blame and more time on supporting each other – and creating healthier environments – our good intentions might result in more than just hurt feelings.

Jennifer Middleton is a family physician who blogs at The Singing Pen of Doctor Jen.

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  • Dorothygreen

    As a physician you know the difference between your conditions relative to those who are obese. It is not the same. People don’t inherit obesity. Those were pretty ignorant folks if they were telling you asthma and car sickness was all in your head.

    No one should be playing the “blame game” in this day and age and I don’t understand why you are implying they do. But neither should a patient be absolved from the responsibility to deal with a preventable disease. If after they are reasonably educated and don’t change, isn’t it time to use a bit of tough love. Telling them that most diseases now are a combination of genetics, environment and personal choices – what do they hear? An equal part for each or oh I have no responsibilty here.
    Addiction is difficult to stop. With sugar, fat and salt it is said to be harder than cocaine. A lot of people live to eat.

    I can understand your frustration. The best you can do is be honest and empathetic without blaming. What is wrong with telling them it is an addiction like tobacco smoking but with even a higher risk. What is wrong with teling them they might have to have their leg cut off sometime if they don’t stop the addiction.

    And, I really don’t see where physicians are helping to change our eating culture. We need a food revolution of a magnitude that will force change. Think about how long and what had to be done to reduce the US tobacco smoking rate.

  • drjoekosterich

    Essentially we see the world through our own eyes and colour it with our own beliefs. The latter can be changed though

  • Merrian Bianculli

    I am a nurse and I live with Ehlers Danlos Syndrome Hypermobility Type. I have had a long list of conditions my whole life. I look perfectly healthy and I exercise and eat well I go to work every day and I take care of my family. It is not easy, but mostly I try not to think about my pain and my dizziness and my fear of falling when my knees and ankles just give out on me. When I asked my physician for a prescription NSAID he said what I needed was a SSRI because I was crying. I was crying because my hands hurt. If he had taken the time to look at my thumb he would have seen an obvious loss of muscle and a hugely swollen joint. I also had x-rays in hand with a reading of “severe osteoarthritis”. People see what makes it easier for them to see. If I took the SSRI script his job would have been done, and I would have been out of his face.

    What is the old saw? Don’t look for zebras when what you are most likely to see are horses? Some of us are zebras though we have learned to hide our stripes.

  • georgemargelis

    Thanks Jennifer. It is important to realise our job is not to blame our patients for their condition, but help them overcome them when possible, and if not help them manage them. This applies as much to some of teh so called lifestyle chronic diseases as it does to the more esoteric autoimmune conditions about which we know so little. It is easy to say that diet and exercise will solve all the chronic disease issues, but in reality we still do not know enough about the underlying condition to know that we are not just shifting from one problem to another.

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