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For Primary Care| View from the ground

Rough Seas and Calm Waters

View From the Ground, by Dr Kim Rollinson

Dr Kim Rollinson

I recently took part in a voluntary parenting course run by my son’s primary school for one evening a week over 6 weeks. When I signed up, I did not expect that it would prove so transferable to my role as a GP. 

On the course, we heard that our 6-year-old kids are learning about anxieties in the context of ‘being on a raft on the sea of life’. Sometimes the sea is choppy, other times it is calm and smooth-sailing. When seas are rough, put your head down and get through it, it will pass. A simple but effective analogy, which I have already used with some patients, is that some people are born to rough seas, while others have pretty smooth waters. We all have periods of choppy water where we struggle, but we learn to steady ourselves with a rudder or oar until it passes.

We talked about how big an impact a parent has on their child’s life through their interactions with them, and I think the same applies to being a GP. We have all experienced brief unsatisfactory exchanges (say in a shop or the post office when the clerk is just grumpy and rude), and those few minutes can really affect your mood for the rest of the day. It made me reflect on the opportunity I have as a GP for a positive impact in my 10-minute slot and how I would like to strive to be kind and upbeat and try to see the positive potential in patients. I know we all have ‘bad days’ when this is hard to achieve, but it is something to aim for.

On the parenting course, we also touched on that buzz word, ‘mindfulness’. It was explained as focusing on and trying to live more in the present moment, and avoiding spending all our time exhaustedly darting between thoughts of regret from the past and concerns about the future. This is something we can encourage our patients with mental health problems to focus on, perhaps even embracing technology and signposting apps such as Headspace,1 a guided meditation/mindfulness programme delivered through short soundbites to listen to through the app.

The course also introduced me to Brené Brown, a psychologist, who discusses the subtle difference between empathy and sympathy.2 Being able to empathise with our children and our patients (and anyone really) during a difficult time is so much better for them than sympathising with them. As a parent, we often find our child’s sadness uncomfortable, and want to ‘jolly them along’, but by just acknowledging their emotions and listening we show them that we are with them on the journey, supporting and allowing their feelings.

As GPs, our role is partly about problem-solving for patients who may be struggling with bereavement, redundancy, or separation to name a few. We should resist trying to ‘silver-line’ the problem, and rather be there with the patient in that moment, acknowledging that this is a tough situation and we are here to listen. Brown comments that empathy rarely begins with ‘at least…’: for example, ‘Max has been expelled’, ‘well at least Jenny is doing well’; or ‘I’ve had a miscarriage’, ‘at least you can get pregnant’; ‘I’m getting divorced’, ‘well at least you have had a marriage’; ‘being a GP is hard’, ‘well at least you work in Scotland!’.

Dr Kim Rollinson

GP, Stockbridge Green Practice, Edinburgh