Herbert M. Adler

The sociophysiology of caring in the doctor-patient relationship

The emotional investment required to construct a caring doctor-patient relationship can be justified on humane grounds. Can it also be justified as a direct physiologic intervention? Two lines of evidence point in this direction. People in an empathic relationship exhibit a correlation of indicators of autonomic activity. This occurs between speakers and responsive listeners, members of a coherent group, and bonded pairs of higher social animals. Furthermore, the experience of feeling cared about in a relationship reduces the secretion of stress hormones and shifts the neuroendocrine system toward homeostasis. Because the social engagement of emotions is simultaneously the social engagement of the physiologic substrate of those emotions, the process has been labeled sociophysiology. This process can influence the health of both parties in the doctor-patient relationship, and may be relevant to third parties.

Toward a Biopsychosocial Understanding of the Patient–Physician Relationship: An Emerging Dialogue

Complexity theory has been used to view the patient–physician relationship as constituted by complex responsive processes of relating. It describes an emergent, psychosocial relational process through which patients and physicians continually and reciprocally influence each other’s behavior and experience. As psychosocial responses are necessarily biopsychosocial responses, patients and physicians must likewise be influencing each other’s psychobiology. This mutual influence may be subjectively experienced as empathy, and may be skillfully employed by the clinician to directly improve the patient’s psychobiology.

Might a psychosocial approach improve our understanding of itching and scratching

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A group-system hypothesis as an explanation of sociologic phenomena

SummaryThis paper attempts to trace the origins of some aspects of human social interaction to the basic social primate need for contact and the basic social primate fear of separation. It is hypothesized that the need for contact may be fulfilled psychologically and symbolically through affiliation with a group and through the adoption of a cognitive perceptual system of ordering phenomena. Thus, the group-system constellation and its vicissitudes may be central factors mediating both mans stability and his change sequences, respectively.

Interpersonal psychotherapy: a communications perspective.

The psychosocial sequences involved in becoming a human being, becoming a patient, and becoming healed are rooted in the need for contact with a parent or surrogate and in the incorporation of his cultural system through the adoption of his communication system.