title: [Chronicity in ambulatory practice: doctor-patient relationship perspectives].
abstract: On the base of his own experience in the doctor's office, as a supervising therapeut in institutions and as a leader of Balintgroups with interns of psychiatry, the author reflects on different aspects of chronicity dealing not so much with the disease of the patient itself as with its relation to the doctor. Thereby reference is made to the danger of typisized acting in relations and stereotypical diagnosis. On the other hand the possibilities of insight in relational perspective shall be demonstrated, e.g. an entrance to the patient favoring the individual experience to the typical and involving the empathic fantasy of the doctor as an instrument of work. From such a point of view, diagnosis become what they are, namely relation-depending interpretations and models of insight and consequently chronicity is looked upon with a primary understanding. Proposition is made to distinguish a "malignant" chronicity from a "benign" one, the former giving way to chronic illness of the patient, whereas the latter means a lasting therapeutical relation open to progress.
mesh_terms: D002908:Chronic Disease; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D010817:Physician-Patient Relations; D011575:Psychoanalytic Therapy; D011613:Psychotherapy
vernacular_title: Zur Chronizität in der ambulanten Praxis: Perspektiven der Arzt-Patient-Beziehung.