Active Systems Observations and Medical Information: A Single Case Study of Measurement of Personal and Empathic Processes

Abstract

There are two major observer systems from which medical information is derived-the neutral observer based system and the active observer based system. The neutral observer based system forms the basis for formal medical science and relies on the science of the independent observer. In the neutral observer based system, the physician is assumed to be neutral, objective, an unbiased scientific observer of the patient. The subjectivity of the physician observations are deemed to be immeasurable or irrelevant medical information. Medical information, in the active observer based system, often taught at the patient's bedside has to grapple with the reality of the uniqueness of each patient and physician. They form an interdependent system where each of them is simultaneously an observer and also the observed. Active observations are ubiquitous in medical practice, but it has been difficult to conceptualize a method to measure and communicate. However, active observer systems can be empirically studied. We describe a set of personal and empathic measurements made by a patient and therapist in psychotherapy concerning the patient's level of functioning according to the Global Assessment of Functioning Scale (GAF) using the active observer system model. The patient's GAF is rated from 4 points of view: the therapist's view (TGAF), the patient's own view (PGAF), the therapist's empathic view (TEGAF) which seeks to estimate the PGAF, the patient's empathic view (PEGAF) that seeks to estimate the TGAF. Using these ratings, this presentation will describe a method to measure the degree of accuracy of therapist's empathy, the degree of patient Over/under-idealization of the therapist's empathic capacity, and the degree of therapist Over/under-confidence concerning his or her own empathic capacity.