Over the past decade the need for the informed consent for medical acts it has become central. When we entrust our most precious asset, Health, a doctor needs to know what lies ahead with the pros and cons. Sometimes, however, the problem of “how far this information should go” seems insoluble.
A fifty-year-old man suffering from panic attacks asks a colleague / student I supervise: How does the therapy develop? What will the sessions be like? If I have to take certain medications for the initial period, what’s in it? Faced with the doctor’s answers, the man becomes urgent, he wants to know in detail what will happen. My colleague begins to get impatient, tries to remain calm but, in his heart, he would like not to take him into care, since he will be a very difficult patient, as he is already discouraged at the start.
With my colleague we try to reason on the fact that every day we we must trust of countless people, if we want to live. As soon as we get up we have to trust the engineer who designed the house where we live, so as not to make it collapse, when we go out in the car we have to trust the mechanic who carried out the maintenance, the tire dealer who screwed the bolts. If we go to the bar we have to trust the person who produced the croissant or the barista who uses an adequate and non-poisonous coffee. Our whole life is based on trust in others. When we stop at the traffic lights, we trust those who regulated it and in the elevator who built it. If we wanted to know and see all the structural calculations of the engineer, the maintenance technician, the mechanic, etc., we would go mad; we would be overwhelmed by information that, among other things, we could not fully understand, given that we lack both studies and experience.
Even in medicine at some point we have to implement a deed of trust in the doctor and no information can be so detailed that we can make a truly informed decision on our own. By the way, in almost all medical situations they exist pros and cons, possible side effects even if rare, options that are statistically equivalent. On the contrary, we are witnessing the fact that many people, when they present suffering, turn to the doctor, then read on the Internet a series of articles for and against medical approaches and end up consulting sites artfully built by barkers who use abstruse terminologies, borrowed from religious and cultural traditions, to attract the customer.
In this period of pandemic we are witnessing surreal debates in which people are asking loudly: what’s inside the vaccine? How does it impact my immune system? What will happen in my body? What effects will I have in 10/20 years? We expect a written and countersigned guarantee that there will be no problems. To disregard the evident efficacy of vaccines (significant drop in all case studies, hospitalizations and deaths), the data are manipulated, using not the percentage, but the absolute data, all the strangest theories are bothered to quibble and question. .
How to get out? Above all, it can mitigate this sense of distrust generalized in which plots are seen on all sides?
We must strive to understand and not to brand all those who do not think like us as ugly, dirty and bad. It is necessary to understand that, when each of us feels at the mercy of events and unable to affect their lives, defense mechanisms psychological that serve to protect the state of mental well-being. A very often used defense mechanism is the projection, for which some of our behaviors or hidden impulses are attributed to others. We can assume that the patient suffering from panic attacks, of which I spoke at the beginning, being in a state of profound malaise, uses the projection, attributing to the doctor hostile feelings which, in reality, he himself cultivates within himself towards the doctor.
In summary, he was forced to go to a doctor due to his malaise, but inside he would not want to do so, as throughout his life he has branded the “mentally ill” as weak and incapable. The paradox is that, by projecting his anger and hostility onto the doctor, he determines a feeling of reaction (which could be called the beginning of controtransfert), of real aversion on the part of the doctor. It is a prophecy that comes true (I am convinced that the doctor is against me, I treat him badly to the point that he will be really aggressive towards me).
Even in the increasingly heated and vehement debate on vaccines we record collective mechanisms projection. Parts of society, frightened and distressed, project their aggression onto other parts of society, equally filled with anguish that they counter with specular anger. The result is a mechanism paranoid, in which an escalation of mutual aggressive behaviors emerges. For example, I read in the newspaper that a teacher wants to enter school without a green pass, the principal prevents her from doing so, she screams and threatens, the principal claims that she reports and calls the police. A few days later “no vax” groups burst into the school to intimidate and scream, a fight ensues. Fortunately, it all ends, but next time we could escape a real aggression and, God forbid, a dead man.
As psychologists we must highlight that the feeling of distress, after a year and a half of fear, it grips us all; our feeling helpless and fragile it causes the projections of our anxieties and anger to take over, leading us to rash reactions. We need to explain the mechanism and, in this way, try to relax tensions and accept our fragility. Only in this way will we be able to rely on the medical profession who will show us the best solution, even if not perfect. And if a certain number of people do not accept the solutions proposed by most doctors, they will still have to accept their decisions, without feeling them as enemies. Rather than peck us like Renzo Tramaglino’s classic chickens Betrothed we accept our differences.