CARTESIANIC DUALISM OR THE ALCHEMY OF MED ICAL EVERYDAY LIFE

Whereas alchemy postulated the unity of body and soul as early as in t he 15th century, Rene Descartes developed an artifical separation of t he body from the soul in the 17th century, a challenge that today's do ctors continue to face. This problematic nature of dualism seems to be suitable for complicating the doctor's relationship with patients of different age groups. With the help of a screening technique and a sem i-standardized interview 100 patients (25 women with RA aged >65; 25 w omen with RA aged <55; 25 women aged <65 without RA and 25 women aged <55 without RA) were examined with regard to their basic needs in the relationships with their doctor. The patients older than 65 showed cha racteristic psychophysical particularities and, as compared with patie nts younger than 55, 86% of them articulated the needs for security as primary need in the relationship with their doctor. Seventy-six perce nt of the younger patients articulated the need for passing on of info rmation as primary need. To understand the world of the elderly means the handling of pseudomorbidity, reduced capability, social death and disease as normality, means the acceptance of the need for a mainly em otional doctor-patient relationship. From the results efficient psycho therapeutical findings can be recommended for the doctor's practical w ork with regard to ''pitfalls,'' as well as for use as the basis for t alks and for a method to use in dealing with elderly people.