ABSTRACT
I will describe in this chapter the experiences that can lead people to being unable to adjust their level of distress, or make use of others to help them. These experiences affect how they respond to offers of assistance and consult with health problems. Nurses and doctors meet many patients who maintain an outward appearance of stoic calm when faced with a grave prognosis. Many will not want to talk about their condition. Clinicians only get worried about some of them. Dismissing type A patients are some of those who puzzle them. Clinicians do not always know what they have noticed. It can be a sense that the patients’ apparent calm is not quite coherent with other signals that they are discomforted. There may even be an ambiguous message creeping through at times of crisis, conveying ‘Don’t ask me how I am, keep your
distance, and please come and take care of me.’ What happens when clinicians feel driven to ask for help to such patients?
