title: Understanding and working with the psychodynamics of practitioner-patient relationships in the manual therapies.
abstract: In this paper, we argue that practitioner-patient relationships in the manual therapies would be strengthened by a deeper understanding of the psychodynamics and emotions of those relationships. We suggest that in many cases, a purely bio-mechanical approach may neglect underlying psychological and emotional reasons of the patient's presenting condition, and consequently, lead to a less than adequate outcome for the patient. We offer easily adopted suggestions that could enhance the practice of practitioners of manual therapies as well as other professions that rely on the application of physical methods of diagnosis and treatment. These suggestions could lead to improved prognosis and increased professional satisfaction for practitioners. This paper describes five key dynamics that characterize practitioner-patient relationships: (i) pain as a form of communication; (ii) the 'heart-sink' patient; (iii) dependency; (iv) the erotic transference; (v) endings and loss.
authors.affiliation: The Tavistock Institute of Human Relations, 30 Tabernacle Street, London, EC2A 4UE, United Kingdom. Electronic address: sherdanny@hotmail.com.
authors.forename: Danny
authors.initials: D
authors.lastname: Sher
authors.affiliation: The Tavistock Institute of Human Relations, 30 Tabernacle Street, London, EC2A 4UE, United Kingdom. Electronic address: m.sher@tavinstitute.org.
authors.forename: Mannie
authors.initials: M
authors.lastname: Sher
mesh_terms: D003142:Communication; D004644:Emotions; D006801:Humans; D007697:Kinesics; D026201:Musculoskeletal Manipulations / Q000523:psychology*; D010146:Pain / Q000523:psychology; D011369:Professional-Patient Relations
keywords: Manual therapies; Psychodynamics; Therapeutic relationship; Transference and counter-transference