Empathy in Psychoanalysis and Medical Education - what can we learn from each other?

Abstract

BackgroundSeveral research areas, including medical education (ME), focus on empathy as an important topic in interpersonal relationships. This focus is central to the use of communication skills related to empathy and even more crucial to provide information in a way that makes patients feel more involved in the treatment process. Psychoanalysis (PA) provides its initial concept of empathy based on affective aspects including findings from neuroscience and brain research. Enhancing cooperation between ME and PA can help to integrate both aspects of empathy into a longitudinal training program.DiscussionThe condition of psychoanalytic empathy definitions is the understanding of unconscious processes. It is important to primarily attend especially the dominant affects towards the patient before interpreting his or her behaviour, since in explaining the emerging affects, the analyst has to empathize with the patient to understand the (unconscious) reasons for its behaviour. A strong consideration of nonverbal communication, clinical perceptions, intuitive interaction, contagion-like processes and their implementation and empowerment in medical and therapeutic curricula is one way of beneficially using interdisciplinary approaches to yield empathy in clinical interaction.ConclusionEstablished methods of PA, like training of containment, reflective functioning, affective holding and giving meaningful interpretations in accordance with countertransferential and transferential aspects may help to put a focus on the clinican-patient-interaction and the preservation of the physicians’ (mental) health. In consequence of the discussion of various training methods that take the theoretical and practical concepts of empathy into account, we aim for an implementation of the named methods in the medical curricula.

Standardized patients in psychiatry – the best way to learn clinical skills?

“…The major goal of the Standardized Patients (SP) Program at the Medical University of Vienna is to effectively train the SP actors to play the role of a patient and to give the students beneficial feedback. An optimal and authentic roleplay as well as adequate feedback facilitates an increase in the students’ communication skills, especially in the field of psychiatric exploration [ 13 ].…”

Empathy is proprioceptive: the bodily fundament of empathy – a philosophical contribution to medical education

“…It also emphasizes a decisive differentiation between self and other and to remain incredulous against the temptation to generalize the own imagination as the leading trait of empathy. Such an attitude can be trained by reflecting on the personal experiences (like drawn above) in the group with other students [ 1 , 36 ]. Then students get confronted with a plurality of experiences, meaning that one interaction with a patient can be understood and bodily experienced in various way according to the involved persons and their perspectives respectively biographic backgrounds.…”

“…It fosters the satisfaction of the patient, supports a better compliance and therefore has an impact on the clinical outcome. An empathetic communication with the patient is in opposition to a paternalistic prescription of a course of treatment [ 1 ]. Thus it is not astonishing medical education (ME) focuses on the training of empathy.…”

Análise dos Níveis de Empatia de Professores e Preceptores Médicos de um Curso de Medicina

“…Na área da saúde, a empatia é definida como um atributo predominantemente cognitivo e não apenas emocional, que engloba a capacidade de entender as experiências, inquietudes e perspectivas do paciente, além da capacidade de comunicar esse entendimento 2 . Outro estudo leva o supramencionado conceito a outro nível, definindo empatia não apenas como uma capacidade cognitivo-emocional, mas como uma complexa interação de processos emocionais, cognitivos e comportamentais 3 . Esse segundo conceito leva em consideração fatores socioculturais nos processos de tomadas de decisão na prática médica.…”

“…Esse segundo conceito leva em consideração fatores socioculturais nos processos de tomadas de decisão na prática médica. O estudo enfatiza que o foco nos fatores socioculturais, sobretudo na educação médica, encoraja a consideração de aspectos psicodinâmicos, psicológicos e psicanalíticos no espectro da empatia 3 .…”