Empathy in Psychoanalysis and Medical Education - what can we learn from each other?

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Abstract

Several research areas, including medical education (ME), focus on empathy as an important topic in interpersonal relationships. This focus is central to the use of communication skills related to empathy and even more crucial to provide information in a way that makes patients feel more involved in the treatment process. Psychoanalysis (PA) provides its initial concept of empathy based on affective aspects including findings from neuroscience and brain research. Enhancing cooperation between ME and PA can help to integrate both aspects of empathy into a longitudinal training program.

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Most cited references 32

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Research in clinical reasoning: past history and current trends.

Geoffrey R Norman (2005)

Research in clinical reasoning has been conducted for over 30 years. Throughout this time there have been a number of identifiable trends in methodology and theory. This paper identifies three broad research traditions, ordered chronologically, are: (a) attempts to understand reasoning as a general skill--the "clinical reasoning" process; (b) research based on probes of memory--reasoning related to the amount of knowledge and memory; and (c) research related to different kinds of mental representations--semantic qualifiers, scripts, schemas and exemplars. Several broad themes emerge from this review. First, there is little evidence that reasoning can be characterised in terms of general process variables. Secondly, it is evident that expertise is associated, not with a single basic representation but with multiple coordinated representations in memory, from causal mechanisms to prior examples. Different representations may be utilised in different circumstances, but little is known about the characteristics of a particular situation that led to a change in strategy. It becomes evident that expertise lies in the availability of multiple representations of knowledge. Perhaps the most critical aspect of learning is not the acquisition of a particular strategy or skill, nor is it the availability of a particular kind of knowledge. Rather, the critical element may be deliberate practice with multiple examples which, on the hand, facilitates the availability of concepts and conceptual knowledge (i.e. transfer) and, on the other hand, adds to a storehouse of already solved problems.

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Empathy: Conceptualization, measurement, and relation to prosocial behavior

Nancy Eisenberg, Richard Fabes (1990)

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Is Open Access

Cross-Species Affective Neuroscience Decoding of the Primal Affective Experiences of Humans and Related Animals

Jaak Panksepp (2011)

Background The issue of whether other animals have internally felt experiences has vexed animal behavioral science since its inception. Although most investigators remain agnostic on such contentious issues, there is now abundant experimental evidence indicating that all mammals have negatively and positively-valenced emotional networks concentrated in homologous brain regions that mediate affective experiences when animals are emotionally aroused. That is what the neuroscientific evidence indicates. Principal Findings The relevant lines of evidence are as follows: 1) It is easy to elicit powerful unconditioned emotional responses using localized electrical stimulation of the brain (ESB); these effects are concentrated in ancient subcortical brain regions. Seven types of emotional arousals have been described; using a special capitalized nomenclature for such primary process emotional systems, they are SEEKING, RAGE, FEAR, LUST, CARE, PANIC/GRIEF and PLAY. 2) These brain circuits are situated in homologous subcortical brain regions in all vertebrates tested. Thus, if one activates FEAR arousal circuits in rats, cats or primates, all exhibit similar fear responses. 3) All primary-process emotional-instinctual urges, even ones as complex as social PLAY, remain intact after radical neo-decortication early in life; thus, the neocortex is not essential for the generation of primary-process emotionality. 4) Using diverse measures, one can demonstrate that animals like and dislike ESB of brain regions that evoke unconditioned instinctual emotional behaviors: Such ESBs can serve as ‘rewards’ and ‘punishments’ in diverse approach and escape/avoidance learning tasks. 5) Comparable ESB of human brains yield comparable affective experiences. Thus, robust evidence indicates that raw primary-process (i.e., instinctual, unconditioned) emotional behaviors and feelings emanate from homologous brain functions in all mammals (see Appendix S1), which are regulated by higher brain regions. Such findings suggest nested-hierarchies of BrainMind affective processing, with primal emotional functions being foundational for secondary-process learning and memory mechanisms, which interface with tertiary-process cognitive-thoughtful functions of the BrainMind.

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Journal

Journal ID (iso-abbrev): BMC Med Educ

Title: BMC medical education

Publisher: Springer Nature

ISSN (Electronic): 1472-6920

ISSN (Print): 1472-6920

Publication date (Electronic): May 02 2017

Volume: 17

Issue: 1

Affiliations

[1 ] Department for Psychoanalysis und Psychotherapy and University Program for Psychotherapy Research, Medical University of Vienna, Währingerstraße 18-20, 1090, Vienna, Austria. henriette.loeffler-stastka@meduniwien.ac.at.

[2 ] Medical University of Vienna, Teaching Center, Postgraduate Program, Vienna, Austria. henriette.loeffler-stastka@meduniwien.ac.at.

[3 ] Department for Psychoanalysis und Psychotherapy and University Program for Psychotherapy Research, Medical University of Vienna, Währingerstraße 18-20, 1090, Vienna, Austria.

[4 ] University of Veterinary Medicine, Teaching Center, Vienna, Austria.

[5 ] International Psychoanalytic University, Berlin, Germany.

[6 ] Emory University, Atlanta, USA.

Article

Publisher Item ID: 10.1186/s12909-017-0907-2

DOI: 10.1186/s12909-017-0907-2

PMC ID: 5414377

PubMed ID: 28464865

SO-VID: 9e7515e3-85f3-4c98-ae06-812c2c0baff5

History

Keywords: Empathy,Medical curricula,Medical education,Nonverbal communication,Psychoanalysis,Training

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Keywords: Empathy, Medical curricula, Medical education, Nonverbal communication, Psychoanalysis, Training

Empathy in Psychoanalysis and Medical Education - what can we learn from each other?

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Abstract

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Journal of Medical Education Research

Most cited references 32

Research in clinical reasoning: past history and current trends.

Empathy: Conceptualization, measurement, and relation to prosocial behavior

Cross-Species Affective Neuroscience Decoding of the Primal Affective Experiences of Humans and Related Animals

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