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December 18, 2012 at 12:09 PMComments: 1 Faves: 0

Interactions with Others Aren't Always as They Seem

By Jeffrey VanWingen M.D. More Blogs by This Author

Sometimes things are not as they seem. Beneath the shell of the obvious lies a deeper, more impacting issue. As a doctor, I occasionally encounter these situations. Missing the deeper issue misses the opportunity to help. Not a week goes by that I do not see examples when people's behaviors cover a deeper issue. In such cases, insight lends to opportunity. The goal of this blog is to help you identify such issues, recognizing them more for what they are and increasing effectiveness in your relationships and interactions with others.

Case 1


Mood and chronic disease go hand-in-hand in a co-dependent relationship. When mood is good, management of the disease seems just fine. In states of depression, anxiety, or stress, however, grasp on the disease gets dragged down. I see this in diabetes, asthma, high cholesterol, and just about any chronic health problem. A key to control is maintaining that positive outlook first and foremost, incorporating a system of checks and balances with a network of support (family, friends, healthcare providers, and compatriots with the same health issues).


I asked a patient to come in and see me because her cholesterol levels were quite high.  Usually the conversation is straightforward in these situations. "Your cholesterol is high, and we have a couple options: change your diet or consider taking something to lower the cholesterol."  With this particular patient, our conversation turned to her eating habits. Since her husband died a couple of years ago, she's been cooking for one. Eating used to be a social time for her and her husband. Together they were aging healthily, but, alone, she's been eating a single meal each day filled with comfort-type foods. 

Clearly, her problems were beyond the surface issues of her cholesterol numbers. I have little doubt that addressing her prolonged grief will help her find hope and meaning and will quickly snowball into improved cholesterol.

Case 2


In difficult interpersonal interactions I strongly suggest that you give people a chance to explain their positions. Obviously, however, there are limits to this. It's not as if we should just throw our hands up and say that the person responsible for the shooting in the Connecticut elementary school "was a deranged fellow with psychological problems. It wasn't really his fault." Likewise, these considerations are not meant to give people a "cop out" of responsibility for their actions.  And I am not telling people on the receiving end that they should be happily walked over by others. Rationality must be maintained and dialogues should proceed logically.


My phone nurse came into my office relaying a frustrating encounter she had with a patient. This patient "bit her head off" about not getting the appointment time she wanted, so I called her to explore the situation further. She eventually revealed that she had been under a tremendous amount of stress with her son. His anxiety and ADHD had been causing problems at school. She felt responsible for his behavior and this load had become overwhelming. She apologized for her irritability, after which, I reaffirmed myself and my office staff as her ally in supporting her and helping with her problems.  We then began to explore avenues for help with her son's problems.

Get to the Root of the Issue

Sometimes certain emotions can be symptoms of a deeper problem. These behaviors exhibit themselves out of character from a person's typical personality. Our natural instinct in these situations is to react and protect ourselves from the attack. Walls can go up, opinions can form, and bridges can get burned.  In this vulnerability, however, the ground can also be fertile for a positive experience through identifying the problem and aligning your perspective with the person's struggle. Communicating that you care and that you are there to help can go along way.

Go deep in your interactions with others. In my field, it's what separates the good doctors from the so-so. The same is true for parents, co-workers, friends, and people in any arena of service (waitress, retail clerk, etc). Some degree of boldness and risk are involved, but I feel that the benefits carry a greater weight. 

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1 Comment

  • thanks Dr V. other peoples feelings and thoughts can definitely be hard to read. I think everyone hides their true feelings/emotions from time to time.

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