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Emotions, narratives and empathy in clinical communication

TLDR
Patients sometimes report that doctors consider them a set of symptoms rather than a person, and skills in taking the patient perspective were among those performed most poorly in a sample of primary care physicians.
Abstract
Patients sometimes report that doctors consider them a set of symptoms rather than a person. A recent article by a patient in a major Norwegian newspaper had the title ‘I am not a knee cap’. The author had suffered a knee injury, but felt that he was treated by doctors merely as a knee cap rather than as a human being. This feeling is hardly unique. In a focus group study a few years ago patients with rheumatic diseases reported similar experiences and emphasized the importance of being seen as an individual rather than a disease entity [1]. Moreover, in an empirical test of the Four Habits communication skills training model Krupat et al. found that skills in taking the patient perspective were among those performed most poorly in a sample of primary care physicians [2].

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O cuidado das condições crônicas na atenção primária à saúde: o imperativo da consolidação da estratégia da saúde da família

TL;DR: The model of care for acute events has failed to respond to health situations dominated by chronic conditions, which has led different countries and several institutions to seek models of Care for chronic conditions.
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Changes in alexithymia following psychological intervention: a review.

TL;DR: Findings from investigations included in this review suggest that alexithymia is partly modifiable with therapeutic interventions as well as considering the practical implications of the findings and offering suggestions for future research.
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The link between perception of clinical empathy and nonverbal behavior: The effect of a doctor’s gaze and body orientation

TL;DR: The outcomes of the experiment confirm that both gaze and body orientation have an influence on the GPE, and the effect of gaze appears to be gender-dependent: in the experiment, males were perceived as slightly more empathetic with patient-centered gaze, while for females averted gaze resulted in higher GPE scores.
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Patients as teachers: a randomised controlled trial on the use of personal stories of harm to raise awareness of patient safety for doctors in training

TL;DR: Involving patients with experiences of safety incidents in training has an ideological appeal and seems an obvious choice in designing safety interventions, but effectiveness of the intervention in changing general attitudes to safety compared to control is unable to demonstrate.
References
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Journal ArticleDOI

The functional architecture of human empathy

TL;DR: A model of empathy that involves parallel and distributed processing in a number of dissociable computational mechanisms is proposed and may be used to make specific predictions about the various empathy deficits that can be encountered in different forms of social and neurological disorders.
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Grasping the intentions of others with one's own mirror neuron system.

TL;DR: Functional magnetic resonance imaging revealed that premotor mirror neuron areas—areas active during the execution and the observation of an action—previously thought to be involved only in action recognition are actually also involved in understanding the intentions of others.
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Social Cognitive Neuroscience: A Review of Core Processes

TL;DR: This review examines four broad areas of research within social cognitive neuroscience: (a) understanding others, (b) understanding oneself, (c) controlling oneself, and the processes that occur at the interface of self and others, and highlights two core-processing distinctions that can be neurocognitively identified across all of these domains.
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Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust

TL;DR: By bridging the divides that separate physicians from patients, themselves, colleagues, and society, narrative medicine offers fresh opportunities for respectful, empathic, and nourishing medical care.
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Modulating emotional responses: effects of a neocortical network on the limbic system.

TL;DR: Functional MRI results provide evidence for a network in which higher regions attenuate emotional responses at the most fundamental levels in the brain and suggest a neural basis for modulating emotional experience through interpretation and labeling.
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