My son went through a phase of shutting down conversation whenever he heard something he didn’t like. I had to explain many times that this was not an effective way to get what he wanted. We spent a lot of time working on the difference between a conversation “starter” and a “shut down.” He had difficulty communicating effectively and spent a lot of time feeling frustrated and misunderstood. Over time his communication skills improved. He learned how to negotiate by using “conversation openers.”

Guilty
Like you, I’ve spent a lot of time in doctor’s offices. Much of that time was wasted, partly because I did not know how to communicate effectively with the doctor. If I had known what to say and how to say it, there might have been better outcomes. I needed the very same skills that I worked so hard to teach my son.

I made a lot of mistakes. You’ve probably made some of them, too. Mistakes are okay, as long as we learn from them. I’m not suggesting that all of our troubles with doctors is our fault. We can only control our own speech and behavior. What the doctor does in response is not our responsibility. And yes, there are some doctors who will not respond well no matter how we behave. Sometimes you do have to walk away.

Shut down versus Starter
Here are a few examples of conversation stoppers and their more productive alternatives:

Shutdown Starter
“I’m a hopeless case.” “I’ve tried a lot of different treatments that haven’t worked.”
“Nobody can help me.” “I’ve seen a lot of doctors without success.”
“You’re my last hope.” “I’m tired and feeling desperate. I need to know you won’t give
up on me.”
So what do you think?
Here are some common situations and a few alternatives. Think about how you usually respond. Does your response open the door for ongoing conversation or does it shut down the conversation? Do you need to change the way you talk to your doctor?

Your doctor writes a prescription, but you’re worried about the side effects. What should you do?
Take the script, then toss it in the trash when you get home
Take the script, then get online and ask your friends what they think.
Tell your doctor you have misgivings about the medicine and ask if there are alternatives.
Your doctor is pleased with your progress, but you want better results.
Go along with your doctor. After all, he/she knows best.
Tell your doctor you’d like to make more progress and ask if there is something more that can be done
You’d like to try a certain treatment, but your doctor hasn’t suggested it.
Accept the treatment you’re offered. If the doctor thought it was worth trying, he/she would suggest it.
Ask your doctor what he/she thinks of the treatment and if you’re a good candidate.
You’ve been fighting the same migraine for days without relief.
Continue to suffer in silence, hoping it will pass on its own.
Go to the ER for some relief
Call your doctor to see what he/she suggests.
You’ve been seeing the same doctor for months without success.
Quietly search for a new doctor and leave without saying anything.
Write an angry letter blaming the doctor for your lack of progress.
At the next appointment, explain your frustration about the lack of progress. Tell him/her that you are considering getting a second opinion.
Your doctor is not a headache specialist. You want to see if a specialist can help.
Make an appointment with the specialist without talking to your doctor.
At the next appointment, tell your doctor you would like to see a specialist. Ask for copies of your records.
You’ve just been to the ER where you were screened for status migrainosus and treated for intractable migraine. Now what do you do?
Crawl in bed to sleep it off. Once you feel better, work hard to catch up.
Call your doctor to let him know what happened. Ask if you need to be seen.
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I’m not going to tell you there’s a right answer. That’s for you to decide. After all, it’s your health so you get to be in charge.

Tammy’s first experience with Migraine started in 1975. Currently disabled by multiple pain conditions, Tammy still uses her expertise to help others. She holds a Master’s degree in Professional Counseling and is a skilled Herbalist and Reiki Master. She shares her extensive experience in both conventional and complementary medicine here at Migraine.com and on her own blog, Brain Storm.