A doctor's approach to difficult people

2017-01-16 10:12

Photo: Management Forum UK

If you work with people daily, you probably have an idea of who or what makes people difficult to interact with. Most times, you are likely to classify certain patterns or individuals traits into boxes. This may help you identify which clients may pose a threat or simply annoy you. Let’s take a step back and try understand why some people are more difficult than others. In the eyes of someone, somewhere, at some point in time, we are all relatively difficult. Our perceptions can easily be influenced by how much power the identified difficult person holds. Bosses, supervisors, team leaders or final decision makers are commonly classified as difficult by subordinates.

When is it OK to be difficult?

Photo: Lateralaction

Since we are human, and no one is perfect, it only makes sense to our egos knowing that we can be difficult every now and then right? Let me clarify what I mean by being difficult. Urban dictionary (http://www.urbandictionary.com/define.php?term=being%20difficult ) defines being difficult by implying that one is deliberately making life hard for others. Synonyms for difficult are challenging, demanding, painful, problematic, tough, bothersome and severe to name a few. As a boss, being fair can be hard, especially when faced with people of different skills level. There is always going to be someone complaining about your leadership style, though that "someone" might be the weakest link in the workplace.

Parents probably have it worse. They have to keep up with self-centred kids wanting junk instead of nutritional food. Some mothers babysit non-stop and wives handle husbands regressing to their most infantile states of behaving. Let us not forget teachers who have to maintain order in a classroom filled with multiple rascals from all walks of life. Health professionals will tell you how infuriating it is working on the night and weekend of payday. I wonder how bartenders and waiters handle drunk, disorderly clients. Personally, I think if you have one of the most difficult roles in society or the community, and are usually fair, you may not necessarily be difficult. You are just fed up, at that point when you snap.

Difficult people in casualty

I still remember working a shift in a government hospital casualty. It must have been one of the major holidays or around the festive season. A young guy had sustained a deep cut to the face, just above his upper lip. He was drunk, loud and bossy. Worst part, for him, his bleeding was literally spraying onto the floor and walls. He was losing blood fast, yet refusing to be sutured (stitched up). From my experience, guys bleeding that much would usually pass out and require a more rigorous resuscitation thereafter. I still remember how difficult I had to be with him. Let’s just say I said a word or two to him, in a roaring voice, and he became straight as an arrow.

There was another incident that didn’t go so well for my team. Another drunk patient (sigh), came in screaming and making demands. It was one of our busiest shifts. We had a lot of sick patients in our consultation cubicles, including gravely injured assaults. We also had a sick feverish child. I was one of only two doctors in casualty. Long story short, drunk guy had a minor ankle sprain and wanted to skip the line. To our alarm, his relative joined his bravado and soon other patients as well wanted to enter the critical consultation area (resuscitation) without permission. The situation got out of hand and we receiving punches and kicks from drunk guy. Fortunately no one was hurt, physically.

Common reasons people give for being difficult

Have you ever been turned back at the till after standing in line for an hour? Or get that “system offline” message at the municipality just as you are about to drop your papers on the counter? Oh, here’s another one: we only accept cash. You took a day off to sort out those overdue bills, left home without eating, got a speeding fine while trying to beat other early birds to it. You didn’t see any notices or weren’t given any word about anything not functioning well. To your surprise, you even had to wait for tellers to have both tea and lunch. Ok, maybe I might have slightly exaggerated the situation. But you get the point I’m driving home.

Photo: Slideshare

Imagine yourself in that situation. And you are still expected to stay calm, and smile with a ‘better luck next time’ attitude. Deep breath. Only a few of us will just walk away without giving “them” a piece of our mind. If it weren’t for security in these places, I swear people would “Hulk-out”. Some of us believe that if you complain too much or raise the obvious mistakes made, someone might eventually lose their job. So instead we apply that Ubuntu cream, or ointment to the hurt.  Others won’t even take a second to swallow saliva. The manager would be summoned immediately!

"Medically" difficult people

The very young and very old are our special people. We somehow let them get away with being difficult to a certain extent of course. People are familiar with mentally unstable difficult individuals. There is some element of fear that determines how we talk to mentally unstable, specifically psychotic individuals. We are talking about your well-known, troublesome schizophrenics. In a rural village set-up, these guys can get almost anything they want. Only outsiders can dare question why. There are also sensitive individuals known to friends and family with depression. If they offend you, you can’t say anything back. Grieving, angry individuals are also exempted from the status quo.

What if I told you there are more conditions?

Photo: kwkakademie

The brain- Organic brain disorders, previous severe head injury

Chronic Illness- Post-ictal Epileptic state, chronic pain

Intermittent- Hypo or hyperglycaemia

Acute confusion- Delirium (including hypoxic or low oxygen states)

Paediatric origin- Mental retardation, Autism spectrum disorder, ADHD

Adults- Personality disorders, General anxiety disorders, Adult ADD, Bipolar Mood Disorder

Sleep Disorders (those associated with irritability, daytime somnolence and low energy)

Males- Low testosterone (associated with irritability)

Females- Premenstrual Dysphoric Disorder (PMDD) - a severe form of Premenstrual syndrome (PMS)

Elderly- Dementia

These are some of the conditions that may make people come across as difficult. In most cases, sufferers of these conditions are not deliberately difficult. Note that not all sufferers may be difficult. Some sufferers may appear difficult because of their world view . They don’t want to be difficult. People often misinterpret personality disorders and think it is something one can “just get over”. In psychology and psychiatry, personality disorders are associated with changes in an individual’s level of functioning. You may have characteristics of a borderline personality disorder but not the diagnostic disorder itself. It is therefore important to seek professional help after taking an online personality quiz, if one is concerned.

Practical advice

Before labeling someone else or one’s self as difficult, take a step back and identify much responsibility one has to carry on their shoulders. And if one feels they are entitled to being difficult, one should consider the alternative: can i let it slide? When dealing with or working with difficult people, avoid verbal exchanges and name calling. Discuss the issue with the relevant human resource department or lodge a complaint if the difficult person is not apologetic. Sometimes employees may recommend professional help for that constantly “extreme” co-worker. In a few cases, we encounter people described clearly in the words of Michael Caine:

“Some men aren’t looking for anything logical, like money. They can’t be bought, bullied, reasoned or negotiated with. Some men just want to watch the world burn”.  Such men or women, are just plain and simple, difficult.

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