Patients Who Sabotage Their Own Success

We all recognize that a fair amount of what we do in our field involves elements of psychology. That’s not something we need be apologetic about, but rather should embrace. I want to plant a seed with you about an aspect of patient care that is rarely discussed openly. I’m talking about patients who sabotage their success, either consciously or subconsciously.

Many of the patients who come to our offices have already experienced their share of disappointments and failures. In some unfortunate situations there is a parent at home who complains that what we prescribe for a child, be it an ophthalmic Rx or optometric vision therapy, is yet another instance of the child wasting the parent’s time and money. Let’s call this exogenous sabotage, where the home environment or perhaps even comments from another professional in front of the child are, to put it mildly, less than encouraging or supportive.

But this is a more covert type of sabotage that is endogenous in nature. And that is the child who is afraid of her or his own success. Put yourself in the mindset of the child for a moment. “Wait a minute”, the child thinks. “If my parents are convinced that I haven’t been succeeding because this vision thing is a big part of what’s been holding me back, then if I wear the glasses or do my therapy I’ll have one less excuse for not being successful”. This child has in essence embraced the struggle, and made peace with lowered expectations. Perhaps even familiar pain that the child is not ready to give up, only to see the bar be raised yet again.

As with attention, there is only so much we can control regarding exogenous factors, but a great deal more we can control through endogenous factors.

Certainly there are many children relieved to find out “I’m not dumb after all”, and respond very well to the appropriate lenses, prisms, and/or filters or more active therapeutic interventions. When all works well, success is iterative and recursive. What I’m suggesting that you keep in mind is that a subset of children will repeatedly lose or break their glasses, or deny that the Rx is helping them, or that therapy is making any difference, because they’re not ready to have blockage removed. Or to have the bar raised.

When you sense this in a child from the outset, you may want to “have a chat” with the child about this in front of the parent(s). In other instances you may choose to ask to chat with the child privately, and be very open an honest with him or her about what to expect. It might be something along these lines: “I know from what your mom has told me how hard things have been. If we get you a pair of glasses that make learning easier, would you be willing to give that a try?” The key is gaining their agreement to give your Rx or therapy a fair chance because it might lessen the struggle, while at the same time not representing it as a panacea. Simply treating the child with that type of respect can make a huge difference.

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