Therapeutic Communication: Dr. Oz Interviews a Woman with Anorexia Nervosa
Kellie Shields
San Joaquin Delta College
Therapeutic Communication: Dr. Oz Interviews a Woman with Anorexia Nervosa
According to Halter (2014), therapeutic communication is crucial to the formation of quality, patient-centered relationships (pg.148).
Valuable communication skills include verbal and non-verbal methods. Nursing students are required to hone their communication skills in order to be most effective during interactions with clients, client families, and colleagues. Many tools are available to effectively improve a student nurse’s therapeutic communication (TC) skills. Observation of a medical professional interviewing a patient provides important information to the student nurse. Examples of therapeutic, and sometimes non-therapeutic, communication skills are displayed by the professional, allowing the learner to identify the differences and opportunities to improve his or her own TC skills.
During the daily television program, The Dr. Oz Show, Dr. Mehemet Oz, MD interviewed, Stacy, a 43 year-old woman suffering from the serious psychiatric disorder, anorexia nervosa. Stacy, who had been suffering from anorexia since her 20’s, weighed just 56 pounds. Her heart rate was 48 beats per minute when Dr. Oz examined her, and she admitted to having multiple hospitalizations for bradycardia (abnormally slow heart rate).
She appeared severely emaciated and frail. According to Dr. Oz, Stacy was in a medical crisis; she was fighting for her life. The video footage at the onset of The Dr. Oz Show provided background into her life history. According to Stacy, she began restricting her food intake during her college years because of poor body image that she associated with her “freshman 15” weight gain. After receiving compliments about the way she looked as she became thinner and thinner, her obsession with food restriction and dieting became stronger. Her mother passed away shortly after college, according to Stacy, and the grief she felt following her mother’s death consumed her and accelerated the severity of her psychiatric disease. Dr. Oz’s purpose for having Stacy on his show was to discuss her condition in hopes that she would seek inpatient treatment at an eating disorder treatment facility. Throughout the interview, several methods of therapeutic communication were evident.
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The doctor opened the interview seated and facing the client in soft stuffed chairs. His manner was calm yet concerned; focus was placed on eye contact between Oz and Stacy. She returned his firm gaze and responded attentively to his questions. Her voice was meek and shaky. Stacy’s skeletal appearance was extreme and caused an obviously visceral reaction to the audience and to Dr. Oz. His questions were primarily open-ended, which Halter (2014) states are “not intrusive and do not put the patient on the defensive” (pg. 153).
In Dr. Oz’s opening question to Stacy, “How does not eating make you feel in control?” the doctor encouraged her to discuss her feelings. Halter (2014) offers that open-ended questions often break down barriers and help to establish rapport between the professional and the patient (pg. 153).
In addition to open-ended questioning, Dr. Oz related to Stacy non-verbally. He maintained an open body position with relaxed arms and hands, while leaning forward at her level to facilitate sharing and openness.
Dr. Oz used two more TC questioning styles with Stacy. He next used a closed-ended question, which according to Halter (2014), can be risky (pg. 153).
The doctor needed to ascertain if Stacy was willing to try to improve her health and seek treatment. Calmly he asked her, “Is this what you wanted out of life?” She was able to answer a firm “no”. In this instance, the closed-ended question was therapeutic because Stacy showed commitment to the process; she was not derailed or shut down. The next question was “projective”, according to Halter (2014).
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Oz posed this question, “Stacy, where is this behavior taking you?” Dr. Oz was asking her to imagine a future without change. He wanted her to project where her life was headed without treatment for her anorexia. He made it clear that continuing to abuse and deplete her body of nutrients would likely end in heart failure and death. With these TC strategies of appropriate questioning, Dr. Oz aligned himself with Stacy. They were bonded together in a fight for her life.
The TC techniques of restating and reflecting were also evident throughout the television interview. Halter (2014) explains that the technique of restating must be used judiciously (pg. 153).
Mimicking or parroting the client dilutes the effectiveness of restating; it can appear mechanical and loses the personal connection that the interviewer is trying to establish (Halter 2014, pg. 153).
Stacy tells Oz that she isn’t welcome on family trips or at family events; in this instance Stacy shows an example of “reflecting”. She reflects that she experiences feelings of sadness and regret when she is shut out from her family’s activities. Dr. Oz replies, “You didn’t go because you weren’t invited?” The aforementioned is an example of “restating”. (Halter, 2014) .
In the final minutes of the broadcast, Dr. Oz encourages Stacy to seek therapy at an inpatient facility. He uses several effective methods of therapeutic communication throughout this decision making period in the conversation. Oz uses silence to allow Stacy time to collect her thoughts. The pause in conversation is brief but effective. Stacy appears thoughtful and encouraged to accept help, as evidenced by her facial expressions of smiling and maintaining eye contact with her interviewer. Dr. Oz, using the TC technique of “giving recognition” (Halter, 2014, pg.154) tells Stacy that her efforts to come on television and share her battle with anorexia are remarkable and must have be difficult, both physically and mentally. The doctor shows personal awareness of the client’s change in behavior, which is a key to using recognition as a TC strategy (Halter, 2014, pg. 154).
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Ending the interview, Dr. Oz “suggests collaboration” (Halter, 2014, pg. 155) by asking Stacy to “enter treatment today”. He emphasizes working with her and the facility therapist to help her heal and recover from anorexia nervosa. Dr. Oz encourages Stacy that change will be possible with collaboration. Collaborative TC facilitates positive change in the client by working together, not “doing things for them”, according to (Halter, 2014, pg. 155).
Stacy ultimately agrees to enter therapy. A second installment of this interview and update on Stacy’s progress should appear later this year, assuming the medical outcome for Stacy is favorable.
Lessons to be learned for nursing students looking to hone their therapeutic communication skills can be found in all types of media. From watching a television program to social media conversations, human interactions can be studied and evaluated. The astute future nurse knows that effective communication is required to establish quality client-nurse rapport. A quality mental health resource, Varcarolis’ Foundations of Psychiatric Mental Health Nursing states, “Effective communication is a skill that develops over time and is integral to the establishment and maintenance of a therapeutic relationship” (Halter, 2014, pg. 164).
References
Berman (Producer) M Titelbaum (Director) S 2014 56 pound anorexic.Berman, M. (Producer), & Titelbaum, S. (Director).
(2014).
The 56 pound anorexic. [Television series episode]. In Dr. M. Oz, (Executive Producer), The Dr. Oz Show. New York, NY: Harpo, Inc. 201402081126391233805299
Halter M J 2014 Varcarolis’ Foundations of Psychiatric Mental Health NursingHalter, M. J. (2014).
Varcarolis’ Foundations of Psychiatric Mental Health Nursing (7th ed.).
St. Louis, MS: Elsevier. 20140130204452350234270
