Love, boundaries, and the patient-physician relationship
N. J. Farber, D. H. Novack and M. K. O'Brien
Department of Medicine, Veterans Affairs Medical Center, Philadelphia, Pa., USA.
Physicians often use their relationships with patients to promote specific
therapeutic goals. Because of their personal histories, values, and biases,
patients may react to physicians in ways that inhibit or enhance the
relationship. The feelings that are aroused may induce physicians to become
overly distant, engendering patient and physician dissatisfaction, or to
become overly involved emotionally, which can have serious psychological
and clinical consequences. We explore how a balance between clinical
objectivity and bonding with the patient is optimal and achievable. The
nature and origin of personal boundaries are described. Boundary
transgressions on the part of the patient are discussed, and the means of
preventing transgressions by both patients and physicians through medical
education, the process of self-awareness, and an exploration of
family-of-origin issues are proposed. Through attention to communication
with patients, the physician can maintain an empathetic yet objective
relationship with the patient.
