LOVE, BOUNDARIES, AND THE PATIENT-PHYSICIAN RELATIONSHIP

Physicians often use their relationships with patients to promote spec ific therapeutic goals. Because of their personal histories, values, a nd biases, patients may react to physicians in ways that inhibit or en hance the relationship. The feelings that are aroused may induce physi cians to become overly distant, engendering patient and physician diss atisfaction, or to become overly involved emotionally, which can have serious psychological and clinical consequences. We explore how a bala nce between clinical objectivity and bonding with the patient is optim al and achievable. The nature and origin of personal boundaries are de scribed. Boundary transgressions on the part of the patient are discus sed, and the means of preventing transgressions by both patients and p hysicians through medical education, the process of self-awareness, an d an exploration of family-of-origin issues are proposed. Through atte ntion to communication with patients, the physician can maintain an em pathetic yet objective relationship with the patient.