Annette Kindlimann helps chronically ill patients develop an understanding of themselves and their situation. The health psychologist enables them to come to terms with the effects of their illness.
Eva Ritter’s (name changed) world fell apart when the neurologist diagnosed her with multiple sclerosis (MS). The 19-year-old is sitting in the practice room distraught. In the presence of the young woman, the neurologist calls the health psychologist Annette Kindlimann. Three days later Eva Ritter is sitting in her practice. She is sobbing. “It is important that the patient talks to us in their own time,” remarked the psychologist. “Tears are all part of it. When your world falls apart, it takes time to put what has happened into words.” Eva Ritter, initially still through sobs, slowly recounts how her symptoms first appeared and how she consulted her GP who then referred her to the neurologist. She lives in fear of “ending up like her elder brother.” He also suffers from MS and is today wheelchair-bound. The family have a tense relationship with him and could never talk about his illness. And of all things her father, the person she confides in and seeks advice from, is now abroad for two months. She does not feel as though she could discuss this with him on the telephone. “What should I do? So far only my best friend knows about it,” was Eva Ritter’s final remark. “When they talk, what’s important to the patient in that particular moment comes out,” observed Kindlimann. The question “What should I do?” signifies that the patient’s life goes on despite the huge shock. After around 45 minutes, Eva Ritter has expressed her most pressing concerns. She is on the path to learning to understand her own MS.
Illnesses such as MS – whose progress cannot be predicted and which damage the central nervous system – cause great fear. Those affected ask themselves “Will it affect my mind? Will it change my personality?” They have to continually revaluate the impact of the disease. For example, a year after diagnosis, Eva Ritter recognised: “I am Eva with MS, not MS then Eva!”
Annette Kindlimann often meets people facing terrible circumstances. The psychologist has long held an interest in what happens to them. As a registered nurse she gained an insight into this field during the first ten years of her career. During this period she obtained her extensive knowledge of biomedical principles and a comprehensive understanding of everyday patient life: “Patients and their relatives clearly expressed what they were going through and what made life easier in the hospital and at home.”
Psycho-education plays an important role in health psychology practice. Annette Kindlimann also applies her nursing expertise in the description of disease processes, diagnostic procedures and treatments. She distributes information based on the research findings of doctor-patient communication. Patients know which information they require and when they would like to receive it. The progression of a chronic illness cannot be predicted. “However, we can identify and evaluate the risk factors together in conjunction with the specialist consultant depending on the issue,” explained Kindlimann. “Study data indicates that MS progresses differently within a family.” This information came as a relief to Eva Ritter in the first consultation. Her own experience of her MS confirmed this was the case.
On her degree course at Zurich University, Annette Kindlimann studied theories about illness and health. “How do people behave in relation to their health? How do they come to terms with their own illnesses? What factors contribute to people staying healthy in difficult circumstances? How is it that people with severe impairments say they are happy? I find such health psychology issues fascinating,” she revealed. Health psychologists apply their expertise at institutional level and in cooperation with individuals. Annette Kindlimann’s professional colleagues, for example, are working on campaigns aimed at preventing disease and promoting health for the Federal Office of Public Health. They produce content for campaigns, support their implementation and evaluate the results. Others advise companies, municipal authorities and health organisations on how to encourage a healthy lifestyle.
Annette Kindlimann works with individuals or small groups. “It’s essentially about improving quality of life. That means something different for every patient,” she added. Patients take the first step by talking about themselves and their situation. Talking is an everyday skill – an anthropological universal. In uncertain or upsetting situations, talking enables people to take stock and to reflect on what has happened and to envisage the future. “You have to express something in order to better understand it. I see talking as a way of dealing with certain visitations and experiences. Not to counteract them but to comprehend them.” Annette Kindlimann used this quotation by Siegfried Lenz in her dissertation where she explored how MS sufferers learn to cope by talking.
At the moment Annette Kindlimann mainly provides consultations for MS sufferers. She works at the practice, carries out home visits and provides consultations by telephone and in writing. “People facing terrible circumstances appreciate having things written down as a reminder and a sign of our therapeutic relationship,” she pointed out. She likes the diverse nature of her job: “Depending on the issue, I discuss with patients the microbiological processes of their medical treatment, communication about their illness at work but also spiritual matters.” Annette Kindlimann’s patients have to come to terms with a somatic disease. If a psychological illness requiring treatment becomes apparent, she recommends specialist practitioners. “Interdisciplinary networking is vitally important in this respect,” she indicated.
People also seek help with unresolved issues they have with themselves. Kindlimann believes Focusing based on the principles of Eugene T. Gendlin is the ideal method. By Focusing patients direct their attention on their own physically tangible experience of an issue or question. This helps them connect with everything that exists in the internal networks. They look for words to describe the experience. This enables a profound understanding of the current situation and to find a coherent answer to unresolved issues.
For example, a patient with MS was considering not disclosing her diagnosis when looking for jobs. She gave good reasons for doing so. However, she had no peace of mind when making applications. When looking for words to express “I have no peace of mind”, it became apparent that keeping quiet about her diagnosis was at odds with her work ethics. Once that had been established, it was no longer a matter of why she concealed the diagnosis but rather when she should disclose it. “She revealed her diagnosis and got the job!” the psychologist smiled contentedly.
Annette Kindlimann’s working life is extremely diverse: “In addition to my work at the practice, I also run workshops for specialists and give lectures.” She teaches psychology in the healthcare sector and writes psycho-educational articles for patients and family members. Health psychology is becoming increasingly important in Switzerland. A post-graduate course in health psychology was established in French-speaking Switzerland in 2016 which Annette Kindlimann is delighted about. “Health psychology has ground-breaking potential for us all. I am very happy in my job.”
Kindlimann, Dr. phil.
Occupation: Health psychologist
Professional qualifications: Specialist health psychologist (FSP), registered specialist nurse (IKP), certified Focusing trainer
Skills: Empathy, expert knowledge, guiding, reframing and relationship development