Friday, February 02, 2007

Psychological Effects of Being a 'Good Patient'

I have a book called Textbook of Social Psychology, and it has some interesting stuff to say about the psychology of being a 'good patient' in a hospital. Here's what it says:

"Patients may be reluctant to disclose information that seems to be trivial; they want to be "good patients" and may feel intimidated by the physician. Indeed, being a "good patient" may be good for the staff but not the patient... While they are well-liked by staff, these patients pay a price:
  • Depersonalization, a loss of personal identity; they now assume identity as a medical insurance number or become the "hernia repair in 214A";
  • Loss of control, a sense that they must sacrifice the freedom normally expected by adults to a set of institutional rules and professional decisions; and
  • Ignorance of matters about which a normal adult would feel a right to know. In some cases, the patient may sink into a state of passive helplessness, which has been linked to depression and to a further erosion of health.

Is the "bad patient" in better shape? Taylor (1979) suggests that being a "bad patient" is a state of psychological reactance, acting in ways to counteract feelings of depersonalization, lost control, being uninformed and helpless... Of course, "bad patients" may also experience adverse effects on their health."

I would really like to hear what people who've been institutionalized think of this. It seems to me that it's even worse for a psychiatric ward to have that effect than if they're being treated for a physical illness, because of the following: a) they are already having trouble psychologically, b) the harm is directly counter to the effect it should have, and c) the system is more expected to understand things like this. And that's even asdsuming the problem is equally bad in physical and mental hospitals. It's probably worse, in fact, because the person is considered to be less capable of understanmding their condition and making good choices.

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