ABSTRACT
BACKGROUND: Successful therapy is influenced by successful communication and a relationship built on trust. Physician empathy and listening skills appear particularly relevant. Based on their empirical experience, general practitioners report special moments in their patients during their medical consultations. Abraham Maslow coined the term "peak experience" for these special moments, which are rare and deeply moving. The present study examines "peak moments" in terms of existence, origin, characterization, doctor perception, and the overall effect on the doctor-patient relationship. METHOD: A qualitative study design was chosen. Interviews with family practitioners were conducted and analyzed using qualitative content analysis by Kuckartz. In order to collect socio-demographic information the participants were asked to complete a short questionnaire. RESULTS: The study participants (n=17) confirmed the existence of peak moments in doctor-patient interactions in their GP practices. These moments came about spontaneously, facilitated by specific communication strategies and intervention measures to support a situation in which peak moments become possible. To bring about a peak moment in patients, specific requirements need to be met on the part of both doctors and patients. Primary care physicians participating agreed that a peak moment led to relaxation and a stronger trust in the relationship between doctor and patient. CONCLUSIONS: Family physicians perceive peak moments to be an important element to build trust between themselves and their patients, for the patients' increased "self-awareness", and to improve the chances of treatment success. To enable peak moment conditions for general practitioners, a framework of health policy measures such as education and training is recommended, along with an assessment of the time needed for doctor-patient interactions.
Subject(s)
General Practice , Physicians, Primary Care , Germany , Humans , Physician-Patient Relations , Referral and ConsultationABSTRACT
O presente artigo constitui o relato do atendimento clínico, por Fátima Flórido, de um paciente com queixas de vazio e apatia, sendo que, no decorrer do processo, configurou-se uma transferência negativa sob a forma de ataques raivosos. A partir de leituras sobre as escutas em psicanálise e as modalidades de adoecimento psíquico e do exame de sua contratransferência; a autora propôs uma reflexão sobre o manejo clínico necessário, a violência apresentada e a alternância entre estados de silêncio e fúria.
This paper reports the clinical treatment of a patient suffering from symptoms of emptiness and apathy. During his treatment, a negative transference came up in the form of anger and accesses of fury. Based on references from the field of psychoanalysis and the modalities of psychic illnesses, as well as by analyzing an occurred countertransference, the author proposes a reflection on how to clinically deal with such cases, on the encountered violence and on the alternation between states of silence and fury.
Cet article rapporte le cas clinique d'un patient qui présente des symptômes de vide intérieur et d'apathie et qui, au cours du processus, a manifesté un transfert négatif sous forme d'attaques de colère. À partir de références sur l'écoute en psychanalyse et des modalités de la maladie psychique, ainsi que d'une analyse de son propre contre-transfert, l'auteur propose une réflexion sur la façon nécessaire de gérer la pratique clinique, sur la violence qui s'est présentée et sur l'alternance entre les états de silence et de fureur.
Este artículo constituye la historia de la consulta clínica de un paciente con quejas de vacío y apatía, siendo que, en el transcurso del proceso, se configuró una transferencia negativa en forma de ataques violentos y furiosos. A partir de lecturas sobre escuchas, en el psicoanálisis, y sobre las modalidades de la enfermedad psíquica y el examen de su contratransferencia, el autor propuso una reflexión sobre la gestión clínica necesaria, la violencia presentada y la alternancia entre estados de silencio y furia.
Der vorliegende Artikel stellt den Fall eines Patienten dar, der an Symptomen von Sinnlosigkeit und Apathie leidet, wobei sich im Verlauf des Behandlungsversuchs eine negative Übertragung in Form von Wutanfällen manifestierte. Anhand der Fachliteratur über das Zuhören in der Psychoanalyse und über die verschiedenen Modalitäten psychischer Erkrankungen, sowie der Analyse ihrer eigenen Gegenübertragung, stellt die Autorin abschließend Betrachtungen an über den notwendigen Umgang mit solchen Situationen in der klinischen Praxis, der manifestierten Gewalt und den Wechselzuständen zwischen Stille und Wut.
