When Your Provider Says, “It’s All in Your Head”

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When Your Provider Says, “It’s All in Your Head”

In a recent conversation with Annette, a young woman who has MS (multiple sclerosis), she described to me the first time she went for a drug infusion which had been prescribed by her neurologist. She arrived for the session using her walker, barely able to keep her balance. Exhausted, she was finally able to get comfortable in the infusion chair. As the nurse began setting up the needle and catheter injection system into her vein, she looked at Annette and asked her, “Are you sure this isn’t all just in your head?” Now, it’s entirely possible the nurse was trying to make a light-hearted joke. But the fact that, a year later, Annette told me the story, still distressed over those words, means that it doesn’t matter if the nurse was making an attempt at humor. She upset Annette at a very horrible and vulnerable time of her life. Those words “all in your head” have plagued patients for centuries. They are a discount; as if the provider doesn’t trust that there’s really something wrong with you. It most often stems from his/her inability to arrive at an accurate diagnosis. When he or she can’t figure it out, they turn it back on you, the patient, rather than admitting their failure. It’s dismissive, and it’s condescending. Further, it isn’t just an occasional dig. The “all in your head” verdict is heard far too frequently, especially by 50 million patients who are diagnosed each year with autoimmune and neurological diseases, or cardiac problems. The great majority of patients who are “blamed” in this fashion are (no surprise here) women. If you have heard those words “all in your head” – or any euphemism that might mean the same thing – then there are some things you should know, and some steps you can take to alleviate it. First, you know your body better than anyone else does!  If something seems “off” and you can’t shake it in a day or two, then by all means, get yourself checked, and do NOT accept any sort of verdict like “wait and see” or “it’s all in your head”. That will require a few things from you. For example, you need to be able to describe your symptoms accurately, see if you can determine any triggers for them, and keep track of dates and times. Those will all be clues your doctor can use.…



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