Week 1: Understanding irritable bowel syndrome

Week 4: Healthy thinking, healthy self

Week 5: Balancing activity and reclaiming your life

Week 6: Maintaining your gains and staying well

Be assertive

Knowing your rights is one thing, but sticking by them is another. It can take a lot of courage to stand up for yourself, especially when you’re in a vulnerable position or caught on the spot. Assertive communication skills can be helpful here. Assertiveness is one of three communication styles, which represent different ways of interacting with and expressing yourself around others. The others include passive and aggressive communication styles. 

Below, we describe each of the communication styles and use Jill as a case example to demonstrate each. Jill is a middle aged woman who has been struggling with severe irritable bowel syndrome for several years. In her most recent appointment, Jill’s doctor tells her to stop coming back to him about her irritable bowel syndrome because there is nothing he can do for her. He tells her that she is making her symptoms worse by worrying about them and that she just needs to get her life in order. He then tries to hurry her out of the room.

Passive communication

Passive communication involves having difficulty speaking up and expressing yourself. To avoid conflict and rejection, you might give in to others, fail to express your needs, have trouble saying ‘no’, or let others take the lead. You may be described by others as a ‘people-pleaser’. This style of communication can lead to misunderstandings and a build-up of resentment over time, as your needs and wants aren’t met. 

  • Example: Jill’s body posture gets smaller and she feels insulted, yet she responds to her doctor by nodding and agreeing with him. She says “Ok Doc, whatever you say” and quickly leaves the consultation room. 

Assertive communication

Assertive communication involves being open and honest, whilst not being overbearing. You effectively express your own needs, wants, opinions, and feelings, whilst also considering the needs and rights of others. You voice your needs and decline unwanted requests with confidence, whilst steering clear of blame and criticism. This style is considered to be the most effective form of communication.

  • Example: Jill remains calm and respectful, and uses confident body language. She does not get out of her seat, despite the doctor’s attempts to move her on. Jill says to her doctor, “Doc, when you tell me to stop coming back and get my life in order, I feel unheard and unsupported. Given how much pain I’m in, I would like it if we could discuss other options for my care”

Aggressive communication

Aggressive communication involves dominating over others. You tend to be overbearing and may be described by others as rude or bossy. Your main aim is to get your way and win an argument. You may fail to listen to others, frequently interrupt people, and use threatening body language to command respect. You may also be prone to blaming, intimidating, criticising, and demanding things from others. This style of communication is damaging to relationships and leaves others feeling victimised.

  • Example: Jill jumps up out of her seat with an angry expression on her face. She waves her arms around and raises her voice as she says “What did you just say!? How dare you speak to me like that, you obviously don’t understand what I’m going through”

In each example, Jill feels hurt by what her doctor said to her. However, her way of expressing the hurt differed depending on her communication style. Can you guess which style worked out best for Jill? Passivity got her nowhere, she just left feeling deflated. Aggression also got her nowhere, and Jill’s doctor was even less willing to help after her outburst. Assertiveness was the best approach for Jill, as it led to her needs being met. Jill’s doctor was empathic and apologised that his comments had hurt Jill. They agreed to make another appointment to discuss Jill’s options further.  

Take a moment to think about which communication style you use most. We all jump between the three from time to time, but think about which one is your ‘default mode’. Perhaps you use different styles in different contexts or with different people. It is not uncommon for people to be less assertive with authority figures, so you may have noticed that you communicate about your irritable bowel syndrome differently when you’re with your family than you’re with your doctor. Do you tend to be quiet, unsure and keep questions to yourself? Or, do you tend to become aggressive in an attempt to feel heard? 

Being passive or aggressive when it comes to navigating the medical system and getting help for your irritable bowel syndrome is unlikely to be effective. On the other hand, becoming more assertive in your interactions with others can help you get your needs and rights met. This applies to the healthcare context and can be the difference between finding a treatment that works and continuing to suffer. It also applies more broadly to your other social interactions, whether it be with friends, family, or work colleagues. Overall, assertive communication can save you a lot of time, heartache and stress.