Even though contemporary medical literature has largely overlooked the curative aspects in the relationship between a patient and a physician, the same is not true in the relationship between the patient and the psychologist. Putting the “techniques” each health care provider is trained to use aside, there is a lot to be said about the interpersonal relationship between the patient and the physician or the psychologist. For the purpose of this blog and wearing the counselor’s hat, I will only address the effects of the relationship between the patient and the psychologist in the patient’s healing process and how certain skills the psychologist uses can be adopted by the patient’s familial environment to facilitate the healing process.
There is vast research examining which interventions are empirically supported and which therapeutic orientations are scientifically proven for their efficacy for specific diseases. However, in the core of the success of treatment is the therapeutic alliance (relationship between the therapist and the client); the better the alliance, the greater the therapeutic gains.
We, as counselors, are trained to use an array of skills for therapeutic change, but regardless of the demands of each individual case, the therapeutic relationship is mostly characterized by:
non-possessive warmth, understanding, positive regard, congruence or genuineness, acceptance, kindness, wisdom, and accurate empathy.
Another important component of the therapeutic alliance encompasses the therapeutic bond and agreement on therapeutic goals, and the tasks employed to achieve them. Lastly, psychologists from almost all orientations encourage people to discuss or confront situations that they avoid or fear, which opens up the opportunity to gain insight into the problem and encourage them to attempt new and life-supporting ways to address it.
One may wonder how counselors cultivate the more subjective and abstract skills. How, for example, does one go about learning how to feel and exude non-possessive warmth and genuineness? Or even harder still, how can someone instruct another as to how to achieve something beyond superficial understanding? Speaking for me, one key factor was/is my life experience and ongoing journey of growth. Also, in order for me to resonate in anything more than a superficial way with my clients, I have to constantly MOVE to do so. In other words, I must shift myself into the other’s perspective and affective life without losing myself in it. Although difficult—and at times even frightening or depressing—such radical shifts in perspective were/are necessary if a health care provider is to offer accurate empathy, unconditional positive regard, non-possessive warmth, and congruence or genuineness.
How is disease viewed?
A disease mirrors an imbalance of the patient; an unresolved internal conflict which has resulted in suppressed feelings usually related to anger, fear, or sadness. Family therapists view the manifestation of a disease as a cry of help from the patient to restore family imbalance, as life is interconnected and in family therapy individuals are viewed as part of a system, i.e., family. When a family member is ill, the illness is a family challenge as the illness does not only affect the person who is ill but the rest of the family as well. It is a challenge that needs to be tackled collectively and coherently by the family. Usually, in situations like these, when the family’s foundation is not solid, there is great risk that partners will grow apart either by blaming each other or by disagreeing on the way forward when they should instead be keeping a positive attitude, a united front, and accept that whatever has happened was an event that they cannot control. However, what they can control is the way they respond to the challenge.
Some tips of how family members can tackle the challenge and support the person who is ill.
- Family members need to be assertive instead of aggressive. I.e.,Assert = DISCUSS their feelings, opinions or beliefs in order to INTELLIGENTLY COOPERATE towards finding the best solution, instead of acting out on their feelings becoming angry, combative or passive
- It is expected that the patient will undergo changes of behavior and mood due to the news but also due to possible physical pain, hospitalization, medication, etc. The patient needs to be calm and feel that s/he is understood. Unnecessary stress can cause the patient to become depressed, angry or make hasty decisions
- The skills of a therapist discussed above also apply to the family members who must keep a POSITIVE ATTITUDE, express their warmth, understanding, kindness, empathy and unconditional positive regard to whatever it is that the patient feels and/or decides for the way forward
- Patients must be encouraged to be ACTIVE and SELF-SUFFICIENT, as much as possible, to help them regain a sense of self-reliance and confidence. LEAD BY EXAMPLE, i.e., take care of yourself and your eating and sleeping habits. Not to mention that if you are exhausted you cannot be of much help to anybody
- Lastly, since during these situations it helps to not feel you are alone in it, REACH OUT to friends and family for SUPPORT; they will be happy to offer it. Or you can consider joining support groups to share your experience and learn from others’ experiences.
POSITIVE RELATIONSHIPS ARE HEALING RELATIONSHIPS and when a person feels loved, respected and understood it can have a profound effect on his/her health. :)
ANDRES-HYMAN, R. C., STRAUSS, J. S., & DAVIDSON, L. (2007). Beyond parallel play: Science befriending the art of method acting to advance healing relationships. Psychotherapy: Theory, Research, Practice, Training, 44(1), 78–89.
HORVATH, A. O.,& BEDI, R. P. (2002). The alliance. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp. 37–69). New York: Oxford University Press.
LARSON, E.B.,& YAO, X. (2005). Clinical empathy as emotional labor in the patient–physician relationship. Journal of the American Medical Association, 293(9),1100–1106.