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[A relationship under the influence : collusive phenomena in clinics]
Friedrich Stiefel1, Céline Bourquin1, Michael Saraga1
1Service de psychiatrie de liaison, CHUV, 1011 Lausanne.
Revue Medicale Suisse
|February 7, 2019
Summary
Unconscious collusion in the clinician-patient relationship, often seen in psychiatry and medicine, arises from shared psychological issues. Recognizing and addressing this phenomenon is vital for effective patient care and a healthy therapeutic alliance.
Area of Science:
- Psychiatry
- Psychology
- Medicine
Background:
- Collusion is an unconscious dynamic within the therapeutic relationship.
- It is prevalent in psychiatry and medicine, particularly when disease and treatments profoundly impact patients and caregivers.
- Existential concerns often heighten the presence of collusion.
Purpose of the Study:
- To define and explore the concept of collusion in the clinical setting.
- To identify triggers and implications of unrecognized collusion.
- To emphasize the importance of recognizing collusion for therapeutic relationships.
Main Methods:
- Conceptual analysis of therapeutic relationship dynamics.
- Literature review on psychological factors in patient-clinician interactions.
- Exploration of case examples illustrating collusion.
Main Results:
- Collusion stems from unresolved psychological issues (e.g., loss, intimacy, control) shared by patients and clinicians.
- Unrecognized collusion can significantly impair the clinician-patient relationship.
- The impact is greater when disease and treatments carry existential weight.
Conclusions:
- Awareness of unconscious collusion is crucial for effective medical and psychiatric practice.
- Addressing shared psychological issues can mitigate negative impacts of collusion.
- Proactive identification of collusion enhances patient care and therapeutic outcomes.
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