You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Every generation of medicine faces unique challenges and crises. For this generation, the Institute of Medicine, America's most influential medical policy organization, has identified a “quality chasm” (IOM, 2001) between the ideal and actual practice of medicine. Among 6 key issues, the IOM highlights that aspects of the doctor-patient relationship that may be crucial for healing are often eclipsed by pressures for efficiency, and a growing reliance on technology.
Medical educators are faced with a challenge. They must find ways to teach not only the technologies of basic medicine, but also evidence-based approaches to professionalism, the doctor-patient relationship, and patient centered medicine (Balint, Ball, and Hare, 1969; Balint, 1969) that underlie effective care. This proves to be a difficult task, given a “hidden curriculum” (Hafferty and Franks, 1994) that undermines basic lessons in medical professionalism. Educational research suggests, for example, that current training models produce decrements in empathic skills (Hojat et al., 2009) and that neglect of feelings (in patient and doctor) is often modeled as a way of dealing with the emotional challenges of medical training (Shapiro, 2011).
This little book, Learning About Emotions in Illness: Integrating Psychotherapeutic Teaching into Medical Education, by Peter Schoenberg and Jessica Yakeley, is an important contribution that offers a solution to the dilemmas just described. The authors explore two simultaneously time-tested and radical methodologies, based in psychoanalytic listening skills, for teaching about emotions in illness and the doctor-patient relationship.
In a series of chapters that can serve as a how-to guide, Schoenberg, Yakeley, and others explore over 50 years of wisdom accumulated in a pioneering psychotherapy training track at the University College of London, in which medical students learn to