Three Types of Encounter in the Healing Arts: Dialogue, Dialectic and Didacticism

Abstract

Western Medical and Psychiatric practice, anchored to its theoretical base of scientific determinism, tends to interventions that are administrative and prescriptive. This is derived from, and reflected in, the way in which knowledge is constructed, and the use of language. While this pattern of practice often works well in acute, circumscribed physical syndromes, it is usually far less effective when dealing with other, more frequently encountered, patterns of distress. In such situations the doctor needs to develop alternative ways of meeting and understanding his patient, which implies change in the ‘metabolism’ of language and knowledge. The discipline and discrimination involved in orchestrating these various kinds of encounter may give us a fresh perspective of ‘holism’. A clinical case is described and a model presented to illustrate and amplify these principles