How Are You Feeling? I Mean Emotionally, How Are You Feeling?

Clinical Communication

Frederic W. Platt, MD, and James T. Hardee, MD


Most doctors tend to undervalue emotions, those in themselves and those in their patients. We tend to assume that we and our patients are rational creatures, driven by ideas and articulated values. We prize thoughts over feelings [1]. Yet many studies have shown that human beings tend to feel first and think afterwards. Most of our actions are primarily motivated by our emotions. As patients we need our feelings to be ferreted out when obscure, and acknowledged whether they are obscure or obvious. As clinicians, our primary goal must include that ferreting out and that acknowledgment [2,3].

 Clinician: So I see that you have been suffering with chest pain and want me to find it and fix it, eh?

Patient: Well yes, Doctor. I’ve been pretty scared by all this. I think it could mean … (silence)

Clinician: OK, let’s talk about the chest pain. Exactly where is it and what brings it on?

Not a rare sort of clinical conversation. This clinician correctly focuses on the symptom (chest pain) and tries to further define it. Since symptoms are the gold of the clinical interview, the clinician is focusing aptly [4]. But what about that business of being scared? What did the patient leave off saying?


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