Heart Failure and Assertive Communication

Living with heart failure is no picnic. It is not something I would wish upon anyone. However, I do think that the reduced energy I experience has forced me into a few healthier habits simply because there is less of me to give. I do not dwell on the little things, so in some ways, I am calmer. Additionally - and this is the hardest thing for me - I'm introducing more assertive approaches to certain situations in my personal life.

A need for change

At work as a human resources manager, I have always conducted myself as an assertive leader. However, in my personal life, I tended to work more by collaboration, not because it was appropriate in every situation, but because that was my comfort zone. I quickly realized this needed to change for the sake of my health, energy, and relationships.

As a younger woman with heart failure, I quickly came to see that every facet of my life would require education, advocacy, and alteration. The burden has been 100% on me to explain to friends why I could not go out to eat. Or the few times I did go out to eat (pre-COVID19), to explain why I needed LOW salt food, and why asking the restaurant to just not to add extra salt was not enough. I had no idea prior to having heart failure that E.V.E.R.Y sauce, cheese, premixed item, bread, and condiment has significant salt and therefore needs to be on the side!

Advocating for yourself

From just these small examples, you can see why assertive communication is so important when it comes to advocating for yourself and your health. If you can master the art of saying what you need to say one time (and having this be effective) it will save you a great deal of energy. This is important when your energy is limited and finite.

So, let’s think about the art of communication in the context of self-advocacy. Not just what we are saying but how we are saying it! Let’s also think about the difference between assertive and aggressive/confrontational communication, because these are not the same thing. Personally, I want to remain diplomatic. I also want people to know that when I say something is important I truly mean it. I dislike having to explain things multiple times or ending up with a result that does not respect my boundaries.

Starting strategies

As a disclaimer, this is a very large topic. If this is something that interests you I would recommend looking for resources online or books/TED talks, etc. As a starting point, some strategies include:¹

• Assess your style
• Use ‘I’ statements
• Practice saying no
• Rehearse what you want to say
• Use body language
• Keep emotions in check (funnily enough, this is actually easier when you are on beta-blockers that reduce adrenaline, haha)
• Start small

On a personal note, if you see a therapist, this is a topic I would recommend you consider speaking to him or her about. A behavioral health provider can ask you follow up questions to help you learn what your style is and think about other important aspects of communication with you. For example, when you finish sentences, does your intonation go up or down? Do you look people in the eye? Are you comfortable with silence or do you find yourself rambling?

A stress management tool

It is interesting to think of assertiveness as a good stress management tool. Stress is something that is a constant battle with heart failure and has a negative correlation with heart health. Perhaps in the New Year, as we continue to likely be in quarantine, this is a good time for us to look at ourselves in the mirror and dig into this topic a little bit more!