Dear Tom,
Thank you for this and your other imputs, I have been reflecting. I had
forgotten about Patrick Casement, but I read a book review / abstract prior
to MRCGP. Reading a book is a huge investment in time, but I will revisit
this text.
Affective communication is about the doctors belief in his message. The
nearest psychotherapy is behavioural. The transference is "you can do it".
The art is to make the step achievable. The commandment is to make the task
one the patient is already seeking to achieve. I do believe that the aim is
to boost the placebo effect. The patient can thereby have more faith that
the next bigger step is now achievable. i do not believe that I can transfer
an emotion, as my happiness with family life is not transferable to other
contexts or other lives. I think this is a far more simplistic view, but it
is the art of the postive and possible.
Yours sincerely,
Nigel
----- Original Message -----
From: "Tom Wengraf" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, November 10, 2001 1:48 PM
Subject: Re: Affective influence
> Judith Norman recently wrote:
> >Dear All,
> >What an exciting idea Nigel has raised about the affective style being
> >important.
> >I'm torn between being carried along with great enthusiasm for the
potential
> >of that, and a sceptical mistrust of anything that will increase
patients'
> >dependance
> >on (me/hosp/med).
>
> Just a quick response:
> This whole and very real problem of 'affect' in professional
health-serving
> relationships is dealt with in a number of contexts.
>
> Judith, your 'eliciting self-efficacy statements' strategy might clearly
> help, but it could also be rather superficial in itself, leading to
'verbal
> compliance' by clients who actually don't believe very fundamentally these
> statements you are anxious that they should make.
>
> At the other end of the spectrum from the rather behaviourist 'eliciting
> positive statements' would be the much more complex (and time-consuming!)
> practice of psychoanalysts working with 'transference' (and
> counter-transference'). I think this needs to be at least thought about,
> particularly since most of us will never be (or want to be)
psychoanalysts.
>
> Wendy Hollway's "The psycho-social subject in 'evidence-based practice'"
> (Journal of Social Work Practice vol.15(1) May 2001 pp.9-22) provides a
> brief introduction to this rich body of work about 'handling affect' (in
> oneself and one's clients). Another and very readable text full of little
> vignettes is Patrick Casement's little book, 'On learning from the
patient'
> (1985 Tavistock).
>
> Can anybody else think of others with 'handy small narratives'?
>
> Best wishes
>
> Tom
>
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