Menzin E. R. (2024).
JAMA internal medicine.
Advance online publication.
https://doi.org/10.1001/jamainternmed.2024.2379
Here is an excerpt:
I have seen many patients struggle with anxiety and obsessive-compulsive disorder. I firmly believe in my obligation to connect them with evidence-based therapy and offer pharmacologic treatment. The cognitive behavioral therapy technique of reframing, which is so useful for treating anxiety disorders, can serve as a useful lens for the disorder itself.1 I try to reframe by pointing out their ability to see patterns and the strengths intrinsic to this nonneurotypical brain. Perhaps with this mindset, they can look at their behaviors with grace.
Physicians are problem solvers by nature and training. When faced with symptoms, we tend to go directly for the cure. When there are no or only suboptimal solutions, we tend to offer sympathy instead of strategy. Rather than apologize, we can reframe build the scaffolding to allow patients to change their thought patterns. As with all strategies, this is not universally applicable. You cannot positively reframe a life-threatening diagnosis; to do so insults and minimizes the patient's distress. There are times to sit with patients as their house crumbles, and there are times to help them reframe the chaos.
Recently, I saw this done in another unlikely corner. I took my 89-year-old father to discuss a shoulder replacement with the orthopedist. "Hang on," the surgeon exclaimed enthusiastically, holding his capable hands in the air. "Before we talk about the surgical options, you tore your rotator cuff skiing Killington at 86? That's amazing!" With that phrase, he reframed my father's injury from the frailty of old age to a badge of athletic honor (though he never saw my dad ski). It does not change my father's difficult decision to live with the tear or a grueling repair. Yet as he uses his right hand to lift his left arm, perhaps he will think of the 50 years of skiing or the feeling of fresh snow beneath his skis. Instead of feeling angry, I now watch him maneuver that arm and recall the family ski trips, the children and grandchildren he taught to ski. Sometimes, we all need kind eyes.
Here are some thoughts:
The article explores the concept of well-being as a complex interplay between internal mental states and external socio-cultural factors. It proposes a holistic view, emphasizing the importance of both internal and external influences on happiness.
The article likely discusses strategies for positive reframing, which involves shifting negative interpretations of situations or experiences towards a more positive perspective. This reframing could be applied to both internal thoughts and emotions, as well as external circumstances.
"Turning a kind eye" is a metaphor for adopting a positive and understanding perspective towards oneself and one's environment, ultimately contributing to greater well-being.