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    %DOCTOR PATIENT MEDICAL MODEL ROLE CONTROL HEAL 921225

     A   significant   aspect   of   any    doctor/patient
relationship  is  the  importance which  the  participants
place upon the question of control of the healing process.
Who does each participant think,  believe, and feel should
be in control;  if control is an issue? Is the question of
control  a  central  issue  to  either the doctor  or  the
patient?   Do  the  doctor  and  the  patient  see   their
relationship  and their roles in terms such that the issue
of control of the healing process is not (or is) a central
issue?

     Some  patients  may  want to surrender control to  an
expert who is expected will fix the disease.  Some doctors
may want codependent patients who want them,  the doctors,
to  be  in  control of fixing the disease.   The  form  of
treatment  which  the  doctor considers as  likely  to  be
effective may be biased by the doctor's sense of  how well
the   form  of  treatment  will  assure  the  doctors   of
continuing to be in control,  to  satisfy the needs of the
doctors.

     Some  patients  may resist surrendering any sense  of
being in control of the healing process to any expert  who
has  essential  technical skills to offer to  the  healing
process.    Such  patients  may  be  more  concerned  with
maintaining a false sense of being in control,  than  they
are concerned with taking  advantage of all possible means
to  promote  their own healing process through  their  own
participation  in  cooperation  with  available  technical
experts.

     Some patients may be dis-eased because they have been
without ease;  and they may not want to face  any sense of
responsibility  for  having lived a life  style which  has
made them more insecure, tense, anxious, and vulnerable to
diseases  than  was necessary.  Such patients may want  to
deny the role which their attitudes,  beliefs,   emotional
life,  and unresolved conflicts may have played in leading
them to be dis-eased;  and so sick. Doctors who want to be
in  control of healing processes  may be willing to try to
take control;  and so they may help such patients in their
denial process,  and  absolve the patients of any key role
in their own healing process.

     Some doctors may feel a deep need to be able to be in
control of their patients'  healing processes,  and so  be
unable to  acknowledge  the  importance to their patients'
healing   process  of  those  aspects  of  the   patients'
reflexive   lives  over which the doctors cannot have  any
control. Such doctors will be unable to recognize and deal
with  those  reflexive aspects of their  patients'   lives
which  play  an important role in  the onset, development,
course, and possible recovery from their diseases. They as
doctors will not be likely to have the freedom,  security,
or competency  to deal with the reflexive aspects of their
relationships with their patients;  for they are likely to
be   exclusively  preoccupied  with  the  demands  of  the
objective  paradigm which dominated their own early  lives
and training.

     We  are unlikely to be able to deal wisely  with  all
the  medical  dilemmas and the increasingly high costs  of
expert  medical  service; unless we become free, able  and
inclined  to  deal with questions such as these,  in  ways
which  are open,  honest and reflexive;  rather than being
trapped  in exclusively objective  research  efforts which
help maintain collusive games of  mutual  self  deception,
addictions and codependencies.

                                                                                                                               
                         (c) 2005 by Paul A. Smith in      
                    (On Being Yourself, Whole and Healthy)  
                                                                                                                               
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