Thursday, August 30, 2007

Healing alliances

How can I optimize the treatment of my patients? How can I provide the best healing experience possible? It begins with a partnership with each patient – a unique healing alliance. How does this alliance develop?


It begins with listening. Listening for a patient’s personal understanding of whatever symptoms brought him or her to me. Dealing with illness or pain can be as emotionally draining as it is physically trying. So I also ask about expectations and anxieties. I listen for small details that might convey meaning. It isn’t uncommon for a patient’s needs to be greater than what can be objectively diagnosed. How else to discover this than by listening?

What follows

The result is shared communication. Shared attention. Shared concern. And how could it stop there? Compassion follows automatically. As does a shared vision of what this person’s life would be like without whatever symptom has initiated this interaction.

This is what it means to say I strive to treat the person, rather than the symptom. This is certainly one of the things that drew me to Chinese medicine in the first place.

The unexpected power of the therapeutic alliance

What I now realize is that this interaction has healing power in and of itself. Progress on the road to healing can begin even before acupuncture, before herbs, or before any kind of treatment. Several clinical studies have demonstrated that there is therapeutic value to this healer-patient interaction. This is why randomized clinical trials are needed, after all. Researchers attempt to control for this phenomenon when testing the efficacy of a new drug or treatment. Otherwise, how would we know when a new treatment was effective beyond this important baseline?

All of this is true for Western medicine, too. There even have been instances in which once-orthodox drugs and treatments were abandoned later because subsequent controlled studies demonstrated that the main variable bringing about the positive outcome was the interaction with the doctor, not the treatment itself. Isn’t that amazing? It’s even true for some surgical procedures, believe it or not. Patients were experiencing healing for reasons other than the specifics of the operation. Doctor and patient expectations can have such dramatic effects on treatment outcomes.

A humble suggestion regarding medical research priorities

Dear mainstream and alternative medicine researchers, please focus more investigative energy on that part of your research that is normally referred to only by way of comparison with a main treatment group -- that phenomenal baseline of healing. Please discover more about how all practitioners can be better healers, regardless of the types of treatment involved. What mind-body phenomena are at work when patients and doctors interact, and how can we enhance these effects? What physiological interactions between the nervous, immune, and endocrine systems are taking place when a healer and a patient establish an alliance?

Until we’ve discovered more, I’ll keep listening for clues from my patients.


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