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Missing the meaning and provoking resistance; a case of myalgic encephalomyelitis

Butler, Christopher Collett and Rollnick, Stephen 1996. Missing the meaning and provoking resistance; a case of myalgic encephalomyelitis. Family Practice 13 (1) , pp. 106-109. 10.1093/fampra/13.1.106

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Abstract

Background The interaction between a clinician and a patient who put his problems down to myalgic encephalomyelitis is described. Despite attempting a patient-centred approach, the doctor acted on his own understanding of the meaning of this diagnosis without gaining proper insight into what it meant for the patient. This failure not only led to damaged rapport, it may have contributed to delayed recovery. Objectives The unsatisfactory nature of this encounter led the clinician to consider more effective consulting techniques. Methods and results A hypothetical interaction is constructed in which the clinician uses reflective listening statements to understand the patient's true meaning of this self-diagnosis. Conclusions Despite well intentioned attempts to be patient-centred through widening the consultation beyond the biomedical to include personal and contextual factors, clinicians may still end up imposing their own medical meaning on patient's words. Damaged rapport is a signal that another tack could be more fruitful and reflective listening is one strategy which enables clinicians to check that they fully understand the patient's meaning. Provoking resistance by following strategies which are not appropriate for the patient might then be avoided.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Mathematics
Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Physician-patient relations; chronic fatigue syndrome; consultation process.
Publisher: Oxford University Press
ISSN: 0263-2136
Last Modified: 30 Jun 2017 03:32
URI: http://orca-mwe.cf.ac.uk/id/eprint/60275

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