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ARTICLE |

Attachment Behavior in Hospitalized Patients FREE

Richard M. Berlin, MD
[+] Author Affiliations

Reprint requests to Department of Psychiatry, Berkshire Medical Center, 725 North St, Pittsfield, MA 01201 (Dr Berlin).


JAMA. 1986;255(24):3391-3393. doi:10.1001/jama.1986.03370240061037
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ILLNESS and hospitalization are major stresses that mobilize intense fears: fears of death, injury, loss of control, stranger anxiety, and separation anxiety. Despite these stresses, most people will enter the hospital and assume the patient role. One important way people adapt to the patient role is by finding a physician who explains their symptoms in a way they can understand. The physician occupies a social position of respect, reverence, and influence comparable with the parental role.1

Many theoretical models (paternalism, legal, economic, religious, physician conscience)2-4 have been proposed to explain the relationship between the physician and the patient. The concept of transference, the unconscious assignment to others of feelings and attitudes that were originally associated with important figures in one's early life, is usually invoked as a major underpinning of the physician-patient relationship. Another model, which complements and extends other notions about interactions between physicians and their patients,

REFERENCES

Adler HM, Hammett VBO:  The doctor-patient relationship revisited: An analysis of the placebo effect . Ann Intern Med 1973;;78:595-598.
Thomasma DC:  Beyond medical paternalism and patient autonomy: A model of physician conscience for the physician-patient relationship . Ann Intern Med 1983;;98:243-248.
Szasz TS, Hollender MC:  A contribution to the philosophy of medicine: The basic models of the doctor-patient relationship . Arch Intern Med 1956;;97:585-592.
Curran WJ:  Breaking off the physician-patient relationship: Another legal hazard . N Engl J Med 1982;;307:1058-1060.
Bowlby J:  Attachment theory, separation anxiety, and mourning , in Hamburg DA, Brodie HKH (eds): American Handbook of Psychiatry , ed 2. New York, Basic Books Inc Publishers, 1975;, vol 6, p 292.
Kolb LC:  Attachment behavior and pain complaints . Psychosomatics 1982;;23:413-425.
MacLean PD:  Brain evolution relating to family, play, and the separation call . Arch Gen Psychiatry 1985;;42:405-417.
Meyer E:  Acute psychologic disturbances in the course of hospitalization of patients with chronic illness . J Chronic Dis 1956;;3:111-121.
Winnicott DW:  Transitional objects and transitional phenomena , in Playing and Reality . New York, Basic Books Inc Publishers, 1971;, pp 1-30.
Lichstein PR:  The resident leaves the patient: Another look at the doctor-patient relationship . Ann Intern Med 1982;;96(pt (1) ):762-765.
Taubman EP:  Reflections on Rachel . South Med J 1985;;78:631.
Grave WJ, Greenbaum DM, Jahre JA, et al:  Who is my doctor? N Engl J Med 1974;; 291:534-535.
Rutter M:  Separation experiences: A new look at an old topic . J Pediatr 1979;;95:147-154.
Kessel N:  Reassurance . Lancet 1979;;1:1128-1133.
Querido A:  Forecast and follow-up: An investigation into the clinical, social, and mental factors determining the results of hospital treatment . Br J Prev Soc Med 1959;;13:33-49.
Stoudemire A, Thompson TL II:  Medication noncompliance: Systematic approaches to evaluation and intervention . Gen Hosp Psychiatry 1983;;5:233-239.

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Adler HM, Hammett VBO:  The doctor-patient relationship revisited: An analysis of the placebo effect . Ann Intern Med 1973;;78:595-598.
Thomasma DC:  Beyond medical paternalism and patient autonomy: A model of physician conscience for the physician-patient relationship . Ann Intern Med 1983;;98:243-248.
Szasz TS, Hollender MC:  A contribution to the philosophy of medicine: The basic models of the doctor-patient relationship . Arch Intern Med 1956;;97:585-592.
Curran WJ:  Breaking off the physician-patient relationship: Another legal hazard . N Engl J Med 1982;;307:1058-1060.
Bowlby J:  Attachment theory, separation anxiety, and mourning , in Hamburg DA, Brodie HKH (eds): American Handbook of Psychiatry , ed 2. New York, Basic Books Inc Publishers, 1975;, vol 6, p 292.
Kolb LC:  Attachment behavior and pain complaints . Psychosomatics 1982;;23:413-425.
MacLean PD:  Brain evolution relating to family, play, and the separation call . Arch Gen Psychiatry 1985;;42:405-417.
Meyer E:  Acute psychologic disturbances in the course of hospitalization of patients with chronic illness . J Chronic Dis 1956;;3:111-121.
Winnicott DW:  Transitional objects and transitional phenomena , in Playing and Reality . New York, Basic Books Inc Publishers, 1971;, pp 1-30.
Lichstein PR:  The resident leaves the patient: Another look at the doctor-patient relationship . Ann Intern Med 1982;;96(pt (1) ):762-765.
Taubman EP:  Reflections on Rachel . South Med J 1985;;78:631.
Grave WJ, Greenbaum DM, Jahre JA, et al:  Who is my doctor? N Engl J Med 1974;; 291:534-535.
Rutter M:  Separation experiences: A new look at an old topic . J Pediatr 1979;;95:147-154.
Kessel N:  Reassurance . Lancet 1979;;1:1128-1133.
Querido A:  Forecast and follow-up: An investigation into the clinical, social, and mental factors determining the results of hospital treatment . Br J Prev Soc Med 1959;;13:33-49.
Stoudemire A, Thompson TL II:  Medication noncompliance: Systematic approaches to evaluation and intervention . Gen Hosp Psychiatry 1983;;5:233-239.
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