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Clinician-Client Connection (or, The Ritual of Medicine)

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In the late 1980s, I attended the first International Congress of Healing in India and met Sai Baba. He spoke to a group of us about helping people heal and of all the things he said a practitioner could do, the most important one was to give people hope. This message stuck with me the last 25-plus years and now there’s growing scientific evidence behind the power of this statement.

You may think that giving people hope is nice and even obvious, but it actually has more import than that. New findings are pointing to the possibility that the "ritual" of medicine itself has a strong influence on a client’s healing outcome. This is fascinating to me as it illuminates the power of the body-mind complex in health and healing.

The ritual of medicine was highlighted in a study done by Ted Kaptchuk when he split 262 adults with IBS into three groups: a control group who didn’t receive treatment; a second group who received sham acupuncture and little interaction with the practitioner; and a third group who received sham acupuncture but with great attention from the practitioner (at least 20 minutes of time as well as compassionate comments and touch).

This study revealed that patients who experienced the greatest relief were those who received the most care. Even if the care was fake, clients still tended to fare better. In other words, the methods of administration of medicine were as important as the medicine itself. This means that a patient’s perception of the practitioner and healing session matters and the way practitioners frame their medicine has significant impact on a patient’s health.

This was further illuminated by another study where researchers set doctors in an fMRI machine in such a way that they could see their patients outside it and administer what they thought was a nerve-stimulating treatment. The results indicated that the doctors gave subtle cues to their patients that neither they nor their clients were aware of. In other words, thedoctors’ unconscious thoughts influenced the treatment administered!

Quantum mechanics describes this relationship in the Uncertainty Principle. It has determined that the process of observing a particle changes the behavior of the particle itself because of the measurement that must take place on one of the particles. Translating this to practitioners and clients, the act of a clinician observing and interacting with a client changes the outcome of the client’s condition because that observation includes subjective measurement. This is powerful indeed!

The clinician-client connection was further accentuated through yet another study published in the Proceedings of the National Academy of Sciences where a team projected images associated with pleasure on a screen for only a fraction of a second (too quick for conscious recognition). The outcomes determined that images patients linked with healing may have had a positive influence on the outcome of their health.

All of these studies lead to a fascinating finding – that the ritual of medicine is extremely important and perhaps as important as the medicine itself. To me, this is amazing and certainly points not just to the mind-body connection but also to the mind-body interaction with the clinician and the clinician’s environment. As practitioners this means it’s equally as important to learn how to administer our medicine as it is to study the medicine itself. How often are we taught that?

Not often enough. Many practitioners don’t attend to how they administer their medicine nor to the environment they provide, let alone to how much time they spend with a client. But beyond the time spent, there’s something else that’s even more important in client improvement – the quality of time spent together. Simply put, this part of the ritual has great impact on a client’s healing outcome.

So if you want to increase the effectiveness of your treatments and improve your clients’ healing potential, it’s important to take into account how you administer your medicine. Now what does this entail?

The ritual of medicine involves the care and environment that the practitioner provides to the client as well as the practitioner’s attitude. Here is a list of possibilities – add to it with your own ideas!

  • Environment – How inviting and calming are your waiting room, office, treatment rooms and equipment? Do they elicit expectations of healing?
  • Speech – This includes how the practitioner speaks to the client and the types of positive, encouraging and caring statements made, such as "I’m so happy to meet you;" "I know how difficult this must be for you;" and "This treatment has excellent results."
  • Time – How much time do you actually spend with a client?
  • Touch – Is encouraging touch a part of the treatment?
  • Perceptions – This includes how the clinician perceives the client, including unspoken and subconscious perceptions, and vice versa.
  • Manner – Do you engage with the client with friendliness, curtness, or indifference?
  • Beliefs and opinions – These influence subtle cues given to clients by the clinician, even subconscious ones such as expectation of treatment outcome, responsiveness to the client, assumed disease prognosis, and liking the client or not.

If you are not a clinician but working toward it, then definitely include these parameters in your preparation process. If you are a client, then look for these factors in your medical session. Choose practitioners who provide your needed sense of care, security and hope. You will have a better healing outcome if you feel such sympatico with your clinician.

I’ve personally experienced the impact of the clinician-client connection. I’ve had people come to me saying, "I know you can help me;" or "Everyone says you can help me." I’ve also had clients tell me how relaxing my clinic is even to the point of coming in just to sit and sip tea because they believe it is so peaceful. In such cases, I’ve often found these clients improve from whatever I do! I know of other practitioners who’ve had this experience as well and perhaps you have, too.

Obviously, there are as many ways to administer medicine as there are clinicians themselves. So how do you want to administer your medicine now? What changes would you make? What could you do differently? How will you think and behave toward your clients now that you know your presentation, interaction, and subconscious cues directly determine their health outcome?

Surely the power of the practitioner-patient relationship underscores what Sai Baba told me all of those years ago about health and healing – that the very best medicine is to give people hope. Now I know why that was such a wise statement – it strongly promotes a positive healing outcome for the client.


Ted Kaptchuk is an acupuncturist, faculty member at Harvard Medical School and author of, The Web That Has No Weaver

"The Placebo Phenomenon", Harvard Magazine, by Cara Feinberg, http://harvardmagazine.com/2013/01/the-placebo-phenomenon, accessed March 2013.

Ibid.

Ibid.

1 comment

  • Comment Link Pamela Hathaway, East West student Thursday, 17 April 2014 15:38 posted by Pamela Hathaway, East West student

    Dear Lesley:
    Thank you so much for this article. I have always believed this to be true, and it is so helpful to have the "data" to back it up. I have forwarded this article to our family's GP, with whom we had a very painful interaction around his "baldly" asking my 11-year-old son about whether he had ever contemplated suicide or killing someone (with no context except to say that if either of these things were part of my son's thought-life, the doctor would have to report them to the authorities). If you knew my gentle, mature, kind son (whose reaction when I talked with him about it afterwards was that it was "wierd" and "really something meant for older kids"), you would understand even more why I was so shocked by this interaction, which was so clearly out of tune with my son and his life. I was especially disturbed because this doctor's practice declares itself to be "integrative" in nature, something we specifically sought out when we came here. What this article confirmed for me is that the practices employed by a given practitioner (whether or not they seem broad-minded) are only as good as the intuition that the practitioner employs regarding the specific patient and their health and health needs.
    Thank you again, and all best wishes for Spring!

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