You have a right to ask for what you want. 
The first book out on assertiveness issues, by Robert Alberti and Michael Emmons has as its title, Your Perfect Right. It is empowering to realize that you have the right to ask for what you want, just as the other has a right to say “Yes” or “No.” Too often people tell themselves are out of line to make their needs known. The truth is that life works better for all of us if we can put our needs and wants on the table. One thing that helps is to use what I call “the turnabout technique.” Just ask yourself if the roles were reversed, would you be offended by the other person asking of you what you are considering asking of them. Usually the answer is “No, it wouldn’t be imposing to ask for that.” Once you realize that, it’s easier to speak up.

Attack distorted beliefs that stop you.
Look at your “self-talk” and do battle with it. Common self-defeating beliefs include:
“It won’t do any good.” How do you know if you don’t try?
“I won’t say it right.” You don’t have to say something perfectly to be heard.
“He won’t listen.” He certainly won’t hear you if you say nothing!

Speak up for yourself with your doctors.
Too often patients make the mistake with their physicians of not bringing up important issues. You need to understand that your doctor visits are for you! Tell your physician all the symptoms you have, the medicines you are taking, and the conditions you have that are being treated by other doctors. That information can help the physician to do a better job. (My wife adds another piece of advice: “Speak up about a medication that makes you nauseous!” She recently did so, and got a doctor to change a medication.)

Also, if you haven’t heard from your doctor regarding test results, call the office. Don’t assume no news is good news. A recent study showed that one out of 14 times, doctors’ offices didn’t contact patients when test findings indicated a need to notify the patient of a concern! 

Choose assertive over aggressive or passive approaches.
Many people stop themselves from speaking up because they mistakenly think that they are

being aggressive for doing so; instead, they are passive and say nothing. Pressure and irritability grow since their needs are not being met, and then they blast away. Afterwards, guilt takes over and they drop back into a passive role and the pressure builds again. That’s a very unfulfilling cycle, isn’t it? 

Others choose the “passive-aggressive” option and use sneaky aggression. They try to make the other feel guilty without appearing demanding or angry.  An example would be saying within earshot of your spouse, “Those who don’t take the time to understand us are insensitive and uncaring!” Typically when this approach is used, people pull away.

The assertive option has the best chance of success. Here’s a great way to understand the differences between aggressive, assertive, and passive. When you are aggressive, you are only expressing your own needs: “You are being a jerk because you don’t understand my pain.” When you are passive, you are only looking at the other person’s needs: “I’d better not bother him with my concerns. It will only rock the boat.” When you are assertive, you are speaking up for your own needs while still taking into account the needs of the other, taking into account both people’s needs: “I know you’ve been really preoccupied with work, and it must be hard to hear about my pain, but it makes me feel closer to you if you listen to how my day went. I’ll try not to belabor it.” When first learning to be a more assertive person, it helps to think of a way to say something where the first clause in your sentence addresses your listener’s needs, and the second clause expresses your needs.

Give the people around you brief written information that helps them better understand your needs.
Two years ago I wrote an article for this newsletter entitled, “How to be a Better Friend, Spouse, or Relative to Someone with FM.”  Many of my clients have found it helpful to give a copy to those close to them. An assertive approach would be to say, “I know you’re really busy, but it would mean a lot to me if you would read this article that explains how I feel and what I need. Thanks!”

Good luck in your efforts to be more assertive and, hence, more fulfilled!

Dr. John Fry is a psychologist in private practice in Newport Beach, Calif. He works with men, women, adolescents, children, and marriages. One of his specialties is working with fibromyalgia patients. His wife has fibromyalgia and he sits on the National Fibromyalgia Association’s Board of Directors. To learn more, go to www.drjohnfry.com.

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This article was originally published in FMOnline vol. 10, no. 2. To view the other articles in this issue, click on the links below. 
 
In the Spotlight
Creating and Maintaining a Partnership with your Doctor
Managing Your Health Begins With Partnering With Your Doctor
Speaking Up for Yourself Effectively: Get More of What You Need Without Alienating Others
For Caregivers Only
 
In the News
“Roadmap for Change” Advances Understanding and Care of FM
Racial Differences in Pain Treatment
Hot Flash
 
NFA News
Awareness Day 2010