Matthews D A, Suchman A L, Branch W T
National Center for Chronic Fatigue, Arlington, Virginia.
Ann Intern Med. 1993 Jun 15;118(12):973-7. doi: 10.7326/0003-4819-118-12-199306150-00010.
Healers must try to understand what the illness means to the patient and create a therapeutic sense of connection in the patient-clinician relationship. A favorable climate for "connexional" experiences can be created through the use of various interviewing techniques. Attending to rapport, silencing internal talk, accessing unconscious processes, and communicating understanding can help clinicians enhance their sensitivity to the subtle clues on which issues of meaning and connection often depend. Several risks are associated with the establishment of closer patient-clinician relationships, including dependence and power issues, sexual attraction, and deeper exposure of the clinician to the patient's pain. Prepared with an awareness of these risks and techniques to address them, clinicians are encouraged to deepen their level of dialogue with patients, to compare their experiences with those of other clinicians, and to thereby develop a more systematic understanding of therapeutic relationships.
治疗师必须努力理解疾病对患者意味着什么，并在患者与临床医生的关系中营造一种具有治疗作用的联系感。通过运用各种访谈技巧，可以营造出有利于产生“联系”体验的氛围。关注融洽关系、停止内心对话、探究无意识过程以及传达理解，有助于临床医生提高对细微线索的敏感度，而意义和联系问题往往就取决于这些线索。建立更紧密的患者与临床医生关系存在一些风险，包括依赖和权力问题、性吸引以及临床医生更深地接触患者的痛苦。临床医生在意识到这些风险并掌握应对技巧后，应加深与患者的对话深度，将自己的经验与其他临床医生的经验进行比较，从而对治疗关系形成更系统的理解。
