[About suffering].
From ancient times the Bible, theology and philosophy have dealt with the problem of human suffering. The German concept of "Leidensdruck" means a "pressure" caused by suffering, which prompts the patient to see a doctor. It is worthwhile to deal with suffering from a holistic point of view as well, which can be described as somatic, mental, social and spiritual forms of distress. As all kinds of human suffering are summed up (reflected by) in the psyche, they are mostly followed by psychopathological alterations (i.e. depression); therefore, it is another reason why it is useful to deal with the problem. If suffering is considered as multi-causal condition, personality elements have to be excluded as they can decrease or increase pain. In addition to aetiological factor, the role of coping and defence mechanisms has to be considered as well. The process of suffering - mainly with chronic diseases - goes along with the increase of pain (e.g. with malignant tumours), or luckily with discontinuation of pain by therapy. In a doctor-patient relationship dealing with suffering, a holistic attitude is needed in order to understand the patient better. It may contribute to what Michael Bálint proposed to doctors who use psychotherapy in their practice: the so-called autogenous picture of the disorder developed by the patient has to be reconciled with the doctor's iatrogenous one. The clearer the perspective, the view of the disease, the better patient compliance can be expected.
Hárdi
István
I
ihardi@freemail.hu
D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D003674:Defense Mechanisms; D006694:Holistic Health; D006801:Humans; D010817:Physician-Patient Relations; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology / Q000628:therapy