I like what Carole said that it needs to be presented to the patient as a choice so the patient can stay in control. My problem is even when presented as I choice, I still feel pressure to say "yes" when caught off guard so even though I'm deciding, I'm doing it reluctantly. Plus I just feel like I need that time to go through the process beforehand...the anticipation, reliving the past experiences, freaking out about all of the things that could happen and dismissing those notions, and then finally, mentally willing myself to go through with it anyway. As miserable as that sounds, I need to do it for myself in order to feel in control and like the choice is really mine. Plus there is a whole lot less distress if everything just goes according to plan. Then I worry that something unexpected will occur at the next appointment and stress about the anticipation of how I might handle that possibility. It ultimately damages the trust relationship for me even if it's well-intended. I think deviating from the plan makes me feel insecure and vulnerable ...in some ways it violates that whole principle of being told what to expect and then following through with that expectation.