The patient-doctor relation: A dialogue between psychology and medicine about adaptation

The doctor-patient relationship, a subject widely debated in the literature, is proposed here indicating adaptation as a meeting ground in which medicine and psychology can dialogue, sharing the same point of observation, while maintaining their specificity of reading phenomena and intervention.Life is a continuous adaptive process whose history is the deterministic and unpredictable result of the interplay of resources, possibilities, constraints, limits and opportunities of both the subject and reality.This formulation of adaptation applies as much to biological development as to psychological development and, despite the difference in observable "materials", offers a common observation vertex.Illness is an almost inevitable event in life and involves the subject in all its bio-psycho-social complexity.Hence, the urge to include the patient with his subjectivity (values, history, emotions, fantasies ...) within the clinical field. This inclusion, however, raises two questions: on the one hand, on the reasons for the eclipse of the interest in subjectivity and, on the other hand, on the potential added value brought by thepresence of the patient’s subjectivity in the clinical field.The logic of the development of knowledge and techniques in medicine explains the reasons for the progressive disinterest in subjectivity, but the same development implies the valorisation of biological individuality. Individuality is not, in itself, subjectivity, but is undoubtedly the way to take into account the singularity of the processes adaptive to the disease.The inclusion of subjectivity, if it appears clearly advantageous for the patient, also offers the clinician the advantage of active participation and adherence to diagnostic and therapeutic pathways. In the patient’s narration of the history of the illness, in fact, one can also trace and understand his adaptive strategy. In particular, the proposal of reading the narration is made by assuming as organizers of the narration the experience of the disease and the expectations towards the caregiver.

Keywords: doctor-patient relationship; adaptation; subjectivity; medical setting

Giovanni Guerra, La relazione medico paziente: dialogo tra psicologia e medicina sull’adattamento in "RICERCHE DI PSICOLOGIA" 1/2021, pp 137-151, DOI: 10.3280/rip1-2021oa11606