Think about the last time a patient yelled at you in anger. How did you react? The last time this happened to me I immediately went on the defensive despite years of training in serious illness communication skills. Afterwards, I thought there must be a better way.

Well on today’s podcast we invite two of our favorite palliative care psychiatrists, Dani Chammas and Keri Brenner, to teach us about going beyond simple communication skills like naming the emotion when interacting with the angry patient (see our podcast on avoiding the uncanny valley for a deeper dive into the dangers of becoming too rote and scripted). As Keri put it in the podcast, we must go beyond “a hammer and a nail” philosophy to approaching anger by developing a toolkit for anger that is vast and varied.

Dani and Kery present three steps for interacting with an angry patient:

Look within: What is this anger bringing up in me? How is this anger making me feel, think, and react?
Ask why: What is underneath the anger for this particular patient? Creating a “formulation” for the patient
Act mindfully: Decide what can we do, and how we can respond therapeutically (and no there is no mnemonic for this step)

Here are some other great references we discussed in the podcast:

And for those interested in other podcast we did with Dani and Keri, check out the following:

The Angry Patient: A podcast with Dani Chammas and Keri Brenner

GeriPal - A Geriatrics and Palliative Medicine Podcast