Empathies” Rather than “Empathy” in The Clinical Context Of General Medicine: Acute Or Chronic Diseases, Physical Or Mental Health Problems and Types Of Doctor-Patient Relationships

Abstract

Empathy has been a widely discussed topic in practice, education, and research. Understanding and recognizing this concept is considered fundamental to medical practice. Thus, it has acquired the status of "ideal" in modern medicine. But, in reality it is a complex and heterogeneous phenomenon. Furthermore, the idealization of empathy has made it difficult to reach a consensus on a definition and the effects of its different components. Thus, it is important to reflect on several aspects: 1. Empathic tendencies can be "risky strengths." Excessive empathy can also be dangerous for the patient. A high level of empathy without a corresponding high level of assertiveness can harm the patient as the doctor forgets her / his professional tasks. Empathy and assertiveness are two axes of the same plane: a high level of empathy must be associated with a high level of assertiveness. There is a certain point where the doctor should no longer adjust to the patient; 2. Empathy must be conceptualized within a broader biopsychosocial approach that includes (in addition to assertiveness) other psychological phenomena that occur in the consultation, and that are interconnected, such as doctor-patient relationship, transference and countertransference and the placebo effect; 3. The empathy-assertiveness of the doctor depends on multiple conditions, some related to the doctor, others to the patient, as such or as people, others to the disease, others to the context. Thus, this empathy-assertiveness can be different in different pathologies, modes of doctor-patient relationship, and in acute disease or chronic disease; 4. Empathy must be rebalanced by a "doctor-centered empathy."