The Interpersonal Dynamics in Clinician–Patient Relationships

Abstract

Factors that contribute to interpersonal dynamics in patient care are described, and it is proposed that patients as well as clinicians can benefit from empathic engagement. The curing versus caring paradigm and the concept of disease versus illness contribute to the development of attitudes that influence empathic behavior in clinical encounters. Certain interpersonal dynamics operate in clinician–patient encounters, including a tendency to bind with others for survival, to comply with the orders of authority figures, and to uncritically accept authority figures, and role expectations as well as clinical environment. Important facets of interpersonal psychodynamics and their impact on empathic understanding in clinical encounters are described, and the placebo effect of empathic relationships, cultural factors, personal space, and boundaries in clinician–patient encounters is also discussed. Emphasis is placed on how listening with the “third ear” and seeing with the “mind’s eye” can enhance empathic understanding in the context of patient care.