• Michel Botbol Board of Directors, International College of Person Centered Medicine; Secretary for Scientific Publications, World Psychiatric Association; Emeritus Professor of Child and Adolescent Psychiatry, University of Western Brittany, Brest, France
  • Sandra Van Dulmen Professor, NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands; and Buskerud and Vestfold University College, Drammen, Norway



Communication between patients and health care providers (HCP) is at the heart of medicine and even more within its person-centered paradigm. Within a person centered medicine (PCM) perspective, it is thus crucial, for both the HCP and the patient, to build on a relationship with the objective to establish a therapeutic alliance and share decision making related to the patient’s health issues and to integrate the subjective aspects (and not only the objective aspects) of these healthIssues.After showing that the effects of communication go beyond mere cognitive and affective sharing, particularly in highly emotional relations, this paper’sobjective is to understand more thoroughly what is transmitted in the patients/HCP relation and how some of the child and adolescent developmental psychiatry processes (i.e., early mother–baby interactions and transgenerational transmission of attachment) provide good models to understand this transmission.Building on these models, the paper will discuss how and at which conditions, the HCP’s narrative empathy plays a major role to access to the patient’s subjectivity through the HCP’s subjective experience.It concludes that, therefore, subjectivity of the HCPs should not be seen as a negative side effect of the patient–HCP (or the patient–team) relation but as a crucial clinical tool in person-centered diagnostics and cares if HCPs are properly trained and educated to use their feelings and representations as tools in individual or collective deliberations. But one has to be aware that there is no empathy without subjectivity.


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