Emotions are ever-present in the context of illness and in the process of medical care and have an enormous impact on the well-being of patients and healthcare providers alike. However, this topic is acknowledged and taught in an inconsistent manner in medical education, and the research that should inform clinical management of emotion is scattered. In this book, we present theory and research on the broad topic of emotions in medical care, providing both basic understanding and practical insights on one of the most vital yet challenging aspects of patient care: recognizing and responding effectively to the patient’s emotions as well as healthcare providers themselves recognizing and tending to their own emotions.
Healthcare providers often understand that emotions are important in the process and outcomes of care, yet frequently report feeling ill-equipped to handle their own and their patients’ emotions effectively. Despite clear evidence that clinicians’ responses to patients’ affective cues are linked to care outcomes, instruction on how to effectively identify and manage emotion in a clinical interaction is not a systematic part of medical education curricula. While high rates of burnout, characterized by emotional exhaustion, depersonalization, and the loss of a sense of personal accomplishment, are reported for medical trainees and practicing providers, there is evidence that emotional intelligence and emotional stability may be protective against burnout. This book seeks to advance healthcare providers’ knowledge of the science of emotion while providing evidence-based guidance on how to apply these principles in clinical practice. New curricular content is provided to offer pathways for developing the skill set necessary to navigate the extraordinary emotional demands of practicing medicine.
This book is organized in three sections: Emotion’s Functions, Clinical Emotional Intelligence, and Emotions in the Culture of Medicine.
The introductory chapter, Emotions in 21st-Century Humanistic Medicine, provides an overview of why emotions are important for patient outcomes, clinician wellness, and the clinician–patient relationship. Other chapters in the Emotion’s Functions section provide transdisciplinary background on the evolutionary, neurobiological, and social function of emotion, the role of emotion in illness, and emotional dialogue in the medical encounter.
Clinical Emotional Intelligence
The Clinical Emotional Intelligence section covers the importance of identifying patients’ emotional cues and provides evidence on the role this plays in the clinician–patient relationship and in clinical outcomes. This section contains chapters on nonverbal cues of emotion, strategies for emotion recognition, the role of emotion in clinical decision making, and available training tools for honing these practices. Other chapters address emotion regulation techniques, and the intersectional relationship between patient and provider background (including gender, nationality, and race/ethnicity), emotional displays, and associated bidirectional expectations and biases that shape clinical interactions and subsequent outcomes. Three chapters are devoted to specific patient populations: pediatric patient encounters, patient populations with impaired affect, and patients with a history of trauma.
Emotions in the Culture of Medicine
The Emotions in the Culture of Medicine section addresses the professional challenges of honoring emotion in a medical culture that praises stoicism and analytical reasoning. One chapter provides strategies for teaching about emotions in healthcare, another describes interventions that can promote emotional wellness in undergraduate and graduate medical trainees, and the concluding chapter focuses on the relationship between emotion and clinician wellness.
Taken together, this volume synthesizes concrete, actionable steps that can be taken to enhance emotional training for the well-being of clinicians and patients alike. We draw on an international cadre of experts in clinician–patient communication, clinician wellness, emotion research, and medical education. We specifically selected authors from across diverse medical specialties, research specialties, and professional perspectives outside of medicine (social psychology, clinical psychology, education, bioethics, occupational therapy, counseling, and public health) to produce a book that provides guidance for all clinicians, trainees, and medical educators, regardless of specialty, degree, or patient population. It is our hope that readers will come away with a new understanding of the importance of effective clinical management of emotion for patient and clinician wellness, new techniques for teaching emotion regulation and clinical communication strategies, an appreciation of the need for new medical education practices to support the role of emotion in the clinical encounter, and tools for beginning to effect the cultural changes necessary to honor emotions in clinical settings.
Rachel Schwartz, PhD
Judith A. Hall, PhD
Lars G. Osterberg, MD, MPH