The Patient's Brain: The neuroscience behind the doctor-patient relationship
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There is a vast literature on what has often been called the doctor-patient relationship, patient-provider interaction, therapist-patient encounter, and such like. However, it is thanks to recent advances within neuroscience, that we now find ourselves in a much better position to be able to describe and discuss the biological mechanisms that underlie the doctor-patient relationship. For example, we now know that different physiological and biochemical mechanisms take part in complex functions, like trust, hope, empathy and compassion, which are all key elements in the therapist-patient encounter. With this neuroscientific knowledge in their hands, health professionals will soon be able to directly see how their words, attitudes, and behaviors activate and inactivate molecules, cortical areas, and sensory systems in the brains of their patients.
This revolutionary new book describes and explains how this new scientific knowledge can be put to great practical use. It shows how, from a neuroscientific perspective, the doctor-patient relationship can be subdivided into at least four steps: feeling sick, seeking relief, meeting the therapist, and receiving therapy. The main advantage to approaching the doctor-patient relationship from a neuroscientific perspective is that physicians, psychologists and health professionals can better understand what kind of changes they can induce in their patients' brains, further boosting the professional's empathic and compassionate behavior.
Written by the author of the critically acclaimed 'Placebo Effects', this book will lead to a better awareness of the potential power that the doctor's behaviour may have on the patient's behavior and capacity for recovery from illness, as well as to better medical practice and social/communication skills. It will be required reading for physicians, psychotherapists, and neuroscientists.
only a few possible but unlikely speculative exceptions. For example, if opium was added to the concoction, it was likely to produce specific analgesic effects. Likewise, bleeding was likely to have specific effects in some circulatory diseases (Shapiro and Shapiro 1997; Benedetti 2008). Therefore, a clear-cut distinction between shamans and ancient doctors is somehow difficult to be made, and this is true until a few centuries ago, when modern scientific medicine emerged (see Chapter 2). For
anxiety 208–9 in deep brain stimulation 209–10 proglumide 213 Hippocratic Oath 41 historical medical practices 19 homeostasis, motivated behaviour 103 Homo erectus, care of the sick 17 hope 124, 149, 151, 186 assessment scales 151–2 beneficial effects on health 152–3 hopelessness 124, 153–4 relationship to stress sensitivity 155 role of noradrenergic systems 155 role of serotonin 155 hopelessness theory of depression 154 hormonal placebo responses 203–4 preconditioning study 219,
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may have an emotional feeling of admiration towards him. Therefore, admiration may represent a very important aspect of the therapist–patient encounter. For example, admiration can be evoked by witnessing virtuous behaviour aimed at reducing the suffering of others, known also as elevation, or by displays of virtuosic skill. In the first case, admiration has to do with social/psychological circumstances, i.e. virtue, whereas in the second case it pertains to another person’s immediate physical
superior temporal sulcus; TPF, temporo-parietal junction. Source: From Hein and Singer 2008 with permission from Elsevier, Copyright 2008. That there are two independent systems for empathic emotional abilities and cognitive empathy is also shown by lesion studies, although some differences are present compared to the organization of Fig 5.13. Shamay-Tsoory et al. (2009) investigated subjects with lesions either in the ventromedial prefrontal cortex or in the inferior frontal gyrus, whose