#143 If you can’t Gray Rock, What can you do?
You can change the way you think.
The pop psychologists and influencers on Tick Tock have recommended that one useful way to handle very aggressive and narcissistic people is to become as quiet and emotionless as a gray rock. In the New York Times piece, author Christina Caron explains, “if you adopt the qualities of a stone, becoming impassive and bland, then you will repel the argumentative, antagonistic people in your life who are itching for conflict.”
This approach has been bandied about so much that it has become a verb: gray rocking. My college alumni magazine featured the story: Q&A: What is ‘gray-rocking’ and why is it trending?
Gray rocking is viewed as a form of emotional disengagement that keeps one from getting deeper into the conflict with the aggressor. For those folks who thrive on the energy of confrontation, coming up against a stoney faced, unemotional person gets boring and they lose interest.
For those in the health or service industry, it is a form of deflection to avoid confrontation. For some reason, perhaps frustration, perhaps a personality disorder, some people are itching for the chance to abuse or demean anyone who is forbidden by the precepts of their job, from returning fire. Some workers need to deflect the confrontation to keep their jobs.
Perhaps becoming a gray rock can work with a neighbor or a stranger on a subway car. For those of us locked into a professional doctor-patient or nurse-patient relationship with “difficult” people, we cannot just check out. Many teachers and other professionals cannot just gray rock. We must honor our professional oaths and make the best of it. To help me, an emergency physician, and my colleagues do this more effectively and to help keep the situation in perspective, we need to change the way that we think about “difficult” people.
When you can’t be a rock
I wrote a book about interacting with challenging patients that was published in 2022. Our thoughts about any event, person, or circumstance in the world determines our feelings about it. Some people love a good snow storm. Some folks hate them. It is not the storm that causes the emotions, it is our thoughts about the storm. The same hold true for challenging people.
It’s not elderly Mrs. Patterson, who always complains about how cold it is in the office, who is the problem. The problem is our thoughts about her. We think: She should be grateful that we see her. She should wear a sweater. She should remember how we took good care of her when she was sick.
First, it helps to understand where they are coming from. They fear what their injury or illness means and that sometimes translates to frustration, aggression, and violence. The parents of young children can behave in an awful fashion while facing the unknown and witnessing their child in pain or distress of any sort. The old lady who complains about everything has taken on victim mentality and feels helpless.
Some challenging people are angry at their discomfort, their wait times, the unfairness they perceive in the system—all of it. They are stressed beyond their ability to handle it. They may lack the resources to get to a specialist or afford some special medication. We do not know what their oppositional behavior is about unless we lean in and ask.
Perhaps they suffer with substance abuse disorder or alcoholism? Perhaps they are experiencing homelessness or have lost their health insurance benefits. Some resource assistance is only available if we know what the problems are.
Ask better questions
Second, we can ask better questions about our patients that spark more curiosity and empathy on our part. What else is true besides being an emphysema patient who keeps on smoking cigarettes? Is that man someone’s father or grandfather? My father developed emphysema after being introduced to cigarettes during his World War II military service. It was a very hard habit to kick.
I can guarantee that the young man found face down drunk near the local liquor store is somebody’s son. I have two sons and if they present with challenging behavior, I would want them to get the benefit of the doubt. I would want the doctors and nurses to hold their negative judgements and look for all the possible reasons that the man might have some altered level of consciousness.
Is that person tired or hungry? All of us get grumpy without our most basic needs being met. Can we extend an act of kindness or some time to settle down and let the agitated person get their stuff together?
Can we remember that most of our interactions with clients, patients, and their families go quite well and folks are appreciative of the professionals who work in medical offices and emergency departments? Can we recall the sweet little smile of the toddler whose dose of acetaminophen or ibuprofen finally kicked in and they are no longer in pain? Those baby grins are the best.
Can we find some alternative solution or appointment or return visit to offer when a patient or her family can’t go along with the plan? Can we find a generic medication or home exercise that might help with her weakness? Can we find a day care center that might help the stressed family for a while?
Could we be wrong?
Third, could you be wrong about the diagnosis? The treatment? The best consultant? The social services that are available. YES, you could be wrong about everything. Acknowledging that we, as the professionals could be wrong about a diagnosis, for instance, should cause us to be more curious and to dig deeper for the cause of certain signs and symptoms. Perhaps the patient or the family are tired of treatment and are ready to take a comfort care or palliative approach. Has this even been discussed?
As impossible as it seems when a person presents with obstructive behavior, still needs help, the approach must be to lean in further. The tactic should not be to deflect like a gray rock but to ask better questions and listen, completely, to the answers. Most of our patients and clients want more than just solutions. They want to be heard and understood. When they cool down, we must sit with them and acknowledge their grievances and concerns. An apology or acknowledgement that someone or something went wrong or not up to par, is an easy way to reconnect with challenging patients and to offer an olive branch of detente.
When nothing you try works with the challenging people and they must be escorted off the grounds by security or local police, please remember this. That person was doing their best or the only thing they know how to do to protect themselves or their family. That doesn’t excuse their behavior, but it makes it more understandable. Sometimes their best is terrible.
Most of our interactions with co-workers, patients, and families are pleasant and productive. Keep looking for those handshakes and those moments when a distressed person turns the corner and starts to ask for a meal or a blanket or a better room. They may ask for a comb to do their hair. That means they are getting a little better.
It would be lovely of all our interactions with people were respectful and courteous. The real world is not all rainbow and unicorns prancing through the work place. People cuss, yell, and insult when stressed out and unable to get their way. Every human has felt this way at one time or another. With this understanding in mind, we can move past the unpleasant interactions with people in our lives even when we can’t become a gray rock.
