How You Can Advocate For Yourself at the Doctor’s Office Using the BRAIN Tool
As a therapist specializing in women’s issues, I hear a lot about women’s experiences with our healthcare systems and, to the great surprise of absolutely no one, it’s often challenging, oppressive, and invalidating. Sometimes it’s downright traumatic.
Here are some of the scenarios I frequently hear about:
Perimenopausal women having their concerns dismissed and having difficulty getting a doctor to offer solutions that work
Women in larger bodies being viewed as fat and unhealthy only (regardless of health status) and being told to just lose weight in lieu of effective treatment or diagnosis
Pregnant and postpartum women being pushed toward or away from particular interventions without a neutral, evidence based discussion of the options
Women in general feeling unheard and dismissed by doctors and/or having their symptoms blamed on mood or anxiety
Providers failing to discuss alternatives or the risks of recommended options
Women with disabilities being spoken to in an infantilizing way that doesn’t include them in treatment decisions
Women of color not being given the same attention, respect, and care that White women are given
Nearly everyone feels that providers do not spend enough time discussing treatment options, including providers!
It’s important to remember that healthcare providers are just… people. And that includes bigots and jerks. It includes people who are terrible, average, or great in their profession. And it includes good people trying their best in deeply flawed systems that aren’t supportive of quality, humane patient care (i.e. systems that force doctors to ask about weight or schedule so many patients that doctors barely have time to meet with each patient).
In my blog post “Women’s Health and Gaslighting: How to Cope and Avoid Gaslighting Yourself” I cover many strategies to help navigate these issues, but in this post I wanted to focus on one specific tool: the BRAIN decision making tool.
BRAIN is a tool to help you ask your doctor the right questions to allow you to make fully informed decisions about your treatment.
Ideally, healthcare providers would be walking you through all the information needed to make fully informed decisions and be able to truly consent, however, this often doesn’t happen. Many studies show that women are often not given the opportunity to have fully informed consent about their treatment and the more marginalized identities the woman holds, the more likely this is to be true.
BRAIN stands for:
Benefits
Risks
Alternatives
Intuition
Nothing
B- What are the benefits of the recommended treatment? If you are pregnant, don’t forget to ask about what benefits for baby might be. Consider which benefits feel most important to you. Ask what the research evidence is.
R- What are the risks of the recommended treatment? (including to baby if pregnant). Everyone has a different risk tolerance and will care more about some risks than others. Consider what is important to you. Include factors such as safety, failure rate, cost, side effects, and things that could go wrong.
A- What alternatives exist and what are the benefits and risks for each? Consider what the scientific evidence is for each option you consider. There are interventions of all kinds (Western, Eastern, alternative, modern, traditional, etc.) that have strong evidence supporting their effectiveness, some have a real lack of evidence supporting their use, and others haven’t been researched much at all.
I- What is my gut/intuition telling me about my options? Your feelings are your body's way of instantly conveying important information to you - what are they telling you?
N- What happens if we do nothing? What if we wait an hour, week, month, or year? Sometimes wait and see is a valuable approach, sometimes a dangerous approach, and most of the time, probably somewhere in between.
Other questions to use to advocate for yourself with your doctor
Can I have some time to think about it and get back to you? You might want to ask for time to consider your decision. How much time do you want? A week, day, hour? Even having 10 minutes alone to think may help you clarify what feels right to you. It also might highlight what additional questions you need to ask or simply help you process your emotions about your decision.
How would you treat this in a thin person? Fat activist and hero healthcare advocate Ragen Chastain recommends folks in larger bodies ask this question when they are being told to just lose weight instead of the problem being treated.
Who do you recommend for a second opinion? Any decent provider will have no problem with you wanting a second opinion. Consider it a red flag if the person is resistant to this idea (assuming you have asked respectfully).
Start Therapy in Los Angeles:
If you would like support in learning how to advocate for yourself, improve your health, or navigate health challenges, consider working with a therapist that specializes in women’s health. At Well Woman Psychology, we understand the unique issues women face when navigating healthcare challenges and will arm you with weight neutral, trauma informed, compassionate, assertive tools to help you feel empowered as you work to maximize your health and take up the space you deserve in this world. Follow these steps to get started:
Reach out for a consultation at Well Woman Psychology.
Meet with a therapist specializing in women’s issues
Start feeling more confident and effective as you pursue healthcare
About the Author:
Dr. Linda Baggett is a Licensed Psychologist and owner of Well Woman Psychology, a boutique therapy practice serving clients virtually in California, Colorado, Illinois, New York, and Washington. Dr. Baggett has devoted herself to helping women for over 20 years and loves helping women to feel more empowered in getting the healthcare they deserve. She is trained in many evidence-based trauma treatments, including EMDR and sex therapy. She also works with clients to heal from trauma, relationship issues, pregnancy loss and miscarriage, infertility, perinatal and postpartum struggles, perimenopause and menopause, body image and size-based oppression.
Disclaimer: This blog is for educational and informational purposes only, is not a substitute for individual medical or mental health advice, and does not constitute a client-therapist relationship.