Why are we ashamed to discuss health problems even with a doctor?
Text: Karina Sembe
The theme of human shame for your own body is not new at all, but, unfortunately, has not ceased to be urgent - and is unlikely to cease. French psychoanalyst Jacques Lacan, to work with the uneasy phenomenon of shame, coined the term hontologie - literally “shaming” or “ontology of shame”. The problem is truly comprehensive, and, as for its bodily component, there can be a variety of reasons for discomfort.
We seem to ourselves too thin or too full, low or tall, not mature enough or, on the contrary, too old. Our body seems to us not quite "beach", and hair - not enough "silky." Questions can cause anything from diction and dexterity to physical strength and endurance, from skin color to gender. Shame is transferred to all areas of the manifestation of physicality and is especially aggravated when the already not beloved body fails to the end: ill health begins to be perceived as payment for its own negligence.
In 75% of cases of standard health complaints, men are ashamed to see a doctor. According to the report of the Health section of the BBC service, it is men who are more often embarrassed at a doctor's appointment. Women, as a rule, are more comfortable to undergo a medical examination, but in some cases they also find it embarrassing to seek qualified help, particularly on gynecology. 92% of women in the UK were engaged in self-diagnosis of gynecological diseases online, and the results of such surveys in Russia are unlikely to be more optimistic. Many young girls are more likely to lose time searching for information in Google, allowing further development of the disease than to go to the doctor and tell him about their symptoms. First of all, they are stopped by the feeling of awkwardness.
When it comes to medical consultation, in the top of difficult decisions among patients of different gender there is a trip to a gynecologist or a urologist, a venereologist and a proctologist - in general, to doctors, whose specialty is essentially a taboo. It is striking that in 2016 we can treat cancer with nanorobots, but we are still confused when buying rectal suppositories. If you scatter obscene synonyms of the penis, vagina or anus in an informal conversation, it seems not always decent, but supposedly fun and defiantly, then the need to inform the pharmacist or doctor that something went wrong with these very organs, for some reason qualitatively different "indecent" - as something to be ashamed of.
There is guilt behind the shame: once the body failed, it means that it was treated incorrectly. Hopelessly outdated stereotypes help us blame ourselves: stomach ulcer means drinking a lot, chlamydia — obviously sleeping with someone, heart problems — there is nothing to smoke about a pack a day, obesity or acne — eating everything. By the way, for people suffering from acne, it is often difficult to overcome the awkwardness in dealing with others precisely because both patients and those around them often refuse to accept acne as a disease, and not as a result of personal hygiene neglect. For women in this respect, it’s not at all easy: gloss says that gender requires us to use all means to achieve perfect, radiant skin.
There is guilt behind the shame: it seems to us that, since the body failed, it means that it was treated wrongly
The issue of guilt is particularly acute in the case of mental disorders. Feeling strong social stigma, suffering from depression or other mental disorders instead of seeking qualified medical care tend to fall into denial and blame themselves for what is happening. At the same time, anxiety disorder is not fundamentally different from the digestive one: both have risk factors and etiological factors, both require correct diagnosis and effective treatment - and yes, both can pass “by themselves”, but to hope for it means to put at risk your own health and increase the likelihood of relapse. In Russia, they turn to psychotherapists much less frequently than in the West. As in other areas of medicine, there is a lack of objective information about the need for treatment. The Russian LGBT community faces challenges in this sense: finding a tolerant sensitive psychotherapist or any other specialist is not easy, and silencing important manifestations of physicality can reduce the effect of treatment to zero.
Health awkwardness unites people of different gender, age and social groups. Many of us are often ashamed to call the head or teacher the reason for going to hospital, continue to be ashamed of talking with relatives, in every way bypassing the problem side, and then finally come to the doctor ... And there too they are ashamed. Here, a lot depends on the doctor and features of the health care system as a whole. The Law "On the Basics of the Protection of Citizens' Health in the Russian Federation" obliges the doctor to reasonably explain to the patient the purpose of this or that treatment method. In fact, it turns out that patients often do not receive explanations and are forced to blindly observe a doctor's prescription or look for information about diagnostic and treatment methods on the Internet.
The Russian health care system today is far from the principles of evidence-based medicine recognized by the world community, and we are often not completely sure whether we are being treated properly. In this state of affairs, unreadiness to talk with a doctor on an equal footing in order to understand what is happening with our body will only increase the feeling of awkwardness and frustration. Moreover, instead of delicate consultation, you can sometimes get a real reprimand, albeit in a hidden form. Patients have to listen to the gynecologists' reproaches in that at 26 they are old-born, but still without children, or in no way will establish regular sex life, or even face an abortion condemnation from the doctor. Among the doctors there are also lovers of indulging in fatschaming and pretending to lose weight urgently as a panacea for acne or allergies.
Patients have to listen to the reproaches of gynecologists in that in 26 they are old-born or have an irregular sex life
There is nothing shameful about taking care of yourself: our body is, albeit complicated, but still a mechanism, and when failures occur, it is important to eliminate them in time. In order to increase the chances of getting qualified medical care, in communicating with the doctor it is important to abandon the role of the delinquent student and take the initiative in their hands. In each area, take the trouble to find a specialist you will have reason to trust. Have regular medical examinations, paying special attention to what has previously failed, whether it is the gastrointestinal tract or the endocrine system. This will not only reduce the risk of detecting the disease at a late stage, but will also teach you to communicate more easily with doctors on the topics of physiology. If you are lucky to find your doctor, be honest with him until the end. Remember that questions about how often you brush your teeth, how many sexual partners you have today, and when you defecated last time, are asked not to ridicule you, but to cure you.
If the description of symptoms invariably overwhelms you, prepare yourself: write down complaints in advance and take notes to the doctor. If during the consultation you still feel embarrassed, honestly inform the doctor about it - a good specialist knows how to calm and relieve tension. If the doctor allows himself incorrect comments and refuses to meet the patient's request for information, this is a reason to look for another doctor, and in an emergency it is worth trying to call for help from colleagues in the department. And most importantly - do not hesitate to ask correct and balanced questions. The patient not only has the full right, but is required by law to make the final decision regarding the method of treatment. So, it is vital for all of us to learn how to overcome shame and learn about everything that happens to our body.
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