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Listen to Respond
Published in Judi Brownell, The Listening Advantage, 2019
While there are a variety of ways to analyze defensive behavior, one of the most useful frameworks was proposed by Jack Gibb (2007). He suggests that we can view behavior on a defensive-supportive scale and work to reduce defensive responses by practicing more productive—what he calls “supportive”—skills. Look at the explanations provided in Box 8.5 and make sure you understand and can identify the behaviors described. Since we all have habitual ways of responding, it will take time and practice to change behaviors so that more effective listening takes place. By providing supportive responses, however, you will be reducing the defensiveness that keeps communicators focused on saving face and defending their position rather than on sharing information and working toward better understanding and improved relationships.
Talk About the Mind-Body Connection
Published in Scott A. Simpson, Anna K. McDowell, The Clinical Interview, 2019
This technique mitigates patient resistance to discussion of the mind-body connection through rapport building (using validation and listening), development of a common language (by using terms favored by the patient), and destigmatization (through delivering psychoeducation). If met with defensiveness or anger, the clinician should validate the patient’s frustrations and then gently remind them that clinicians are not here to place judgment or determine what is a true physical symptom. Rather, clinicians seek to provide well-rounded, holistic care that helps the patient achieve their goals. It can be helpful to describe mental health interventions as simply another “tool in the toolbox” of treatment alongside exercise, good nutrition, and medications.
Introduction
Published in Stephen Mackenney, Lars Fallberg, Protecting Patients’ Rights?, 2018
Lars Fallberg, Stephen Mackenney, John Øvretveit
The first is a change in thinking about the cause of ‘complaints’ and ‘mistakes’. The traditional view is that the source of quality is the individual professional practitioner. A patient complaint is likely to be made either because the professional’s ‘bedside manner’ or social skills were poor, which is not serious, or because there was a medical error or mistake due to an individual’s incompetence or laziness. The defensiveness with which complaints are viewed is not surprising, given the traditional education and socialisation of health professionals and also the need which both patients and professionals have to believe in the professional’s omnipotence.
Revisiting the dynamic comprehensive model of self-awareness: a scoping review and thematic analysis of its impact 20 years later
Published in Neuropsychological Rehabilitation, 2022
Support for the relationship between executive function and self-awareness exists, but it is unclear whether the severity of executive function deficits differentially impacts general versus online self-awareness or response to treatment. Initial research on the interplay between psychological factors and self-awareness has been conducted by Medley et al. (2010), who explored belief schematas with measures of awareness and coping, and Ownsworth et al. (2007), who examined self-awareness typologies based on neuropsychological and psychological measures, including the level of defensiveness. However, no empirical research focuses on how the interplay of these factors impacts response to treatment. Areas needing more attention include the process of emergence of online and general self-awareness – how they are influenced by personal, psychological, cognitive, and contextual variables, and how they change across treatment and recovery.
Personality characteristics and cognitive appraisals associated with self-discrepancy after severe traumatic brain injury
Published in Neuropsychological Rehabilitation, 2020
Elizabeth Jane Beadle, Tamara Ownsworth, Jennifer Fleming, David H. K. Shum
Consistent with the findings for optimism, defensive personality characteristics were positively associated with self-discrepancy, albeit modestly. Hence, individuals excessively motivated to present themselves in an overly favourable light were less likely to make unfavourable comparisons between their pre-injury and post-injury attributes. Defensiveness was positively associated with ratings of current self-concept but did not influence individuals’ ratings of their past or pre-injury attributes. Further, defensiveness was not related to threat appraisals, rumination and reflection or perceived coping resources. Previous TBI research has identified that although individuals with high defensiveness may deny or downplay their impairments in certain contexts, they can still develop adaptive coping strategies to accommodate the effects of their injury in order to maintain a positive self-image (Ownsworth et al., 2007; Ownsworth & McFarland, 2004).
Sealing-over in a Therapeutic Community
Published in Psychiatry, 2019
Thomas H. McGlashan, Steven T. Levy
The ‟out of touch” patient presents vexing problems for a group committed to understanding. When the sealing-over process extends to the entire therapeutic community, a characteristic stalemate ensues. Communication and roles within the milieu become stereotyped: the patients act crazy, the nurses and aides try to control them, and the doctors interpret without participating. No one is willing to take risks and explore. Everyone withholds and the therapeutic community meetings become monotonous showcases in which no one expresses any feelings, ideas, or opinions, except to point out everyone else’s resistance. Staff members tend to become angry at the patients for not ‟producing” and to focus upon the patients’ defensiveness. In so doing, they avoid facing their own feelings or fantasies about the patient and devalue these as legitimate and valuable sources of information. The group becomes populated with sophisticated commentators and everything gets noted and commented upon but nothing gets expressed. Such a community operates under the hidden assumption that to have feelings is forbidden and to express them is crazy. The community becomes filled with pseudocred ible interactions that in actuality are out of touch.