Les Émotions dans la Relation Thérapeutique

The Sciences, Normes et Démocratie (SND) team of Sorbonne Université is proposing a collaboration with Stanford University's Medicine and the Muse program and the Integrated Research Site on Cancer (SiRIC) CURAMUS to explore the presence, role and value of emotions in the therapeutic relationship. This two-days conference will take place in Paris on the 4th and 5th of September 2019.


Les places sont limitées dans certains amphithéâtres; l'inscription est donc obligatoire.


What role do emotions play in the therapeutic relationship?

If, historically, medicine was defined as the art of healing, it seems to have acquired its status as a science through focusing on searching for the objective causes of illness. Does this aim entail putting aside emotions, which are seen as subjective and psychological features related to patients’ and medical practitioners’ experiences, and thus not to be considered in a therapeutic relationship entirely turned towards eliminating disease? Since Antiquity, “good doctors” have been perceived as being wise, able to distance themselves from emotions and not to let themselves be overtaken by the sadness, fear or melancholia that being confronted to illness and death on a daily basis can bring forth.

However, one can point out that emotions were an integral part of health and illness as defined in the humoral system of medicine - a system which was centered on balance and based on air, diet, sleep and waking, exercise and rest, secretions and excretions, affections or passions of the soul. The idea that emotions have a role to play not only in the onset of illness but also in restoring health is therefore not a recent one. It has given rise to the so-called tradition of the "regime of the mind" which emphasizes the influence of the soul on the body as well as the way this interaction can be used to prevent diseases, or even cure them.

What about the therapeutic relationship between medical practitioners and patients nowadays? Acknowledging the role of emotions in curing diseases, calling for more empathy on the part of doctors or using meditative practices based on the awareness of emotions is to recognize their significance in the therapeutic relationship, be it in the field of somatic medicine or psychiatric medicine. When these types of practice are developed, they also emphasize the limits of a purely biomedical approach of care centered on effectiveness and on distancing oneself from being affected by emotions. They can bring forth strong criticisms against evidence-based medicine and favor alternative approaches to care, perceived as more likely to take into account the influence of the mind over the body (alternative medicine and ideas of "disease management" through emotions, which can go as far as refusing medication or surgical interventions, and up to a form of "medical nihilism").

The aim of this conference is to ask if we are indeed really confronted with an alternative between a kind of medicine which is unemotional, therapy-oriented, looking into the causes of diseases, and a more preventive approach to medicine, concerned with people, their experiences and the influence of the mind on the body. Is it not possible to integrate emotions into the practice of not only preventive but also curative, surgical and palliative care?
The question seems particularly urgent in the context of serious diseases such as rare cancers, to which affectively-charged representations are attached (fear of death, anxiety about the side-effects of treatments, hopes of healing...), both by caregivers and patients. A medical practitioner disclosing such a diagnosis and making treatment suggestions must take into consideration the emotions that his announcement can arouse in the patient.

But the question also arises with regards to the medical practitioner, who is asked to show "empathy" and who can at the same time feel discouragement and helplessness in his or her daily practice.

Emotions also play a large role when caring for traumatized patients, as was the case at the Pitié-Salpêtrière hospital during the terrorist attacks of November 2015 in Paris, or in psychiatric services where the management of mental illness cannot sidestep the issue of emotions expressed by the patient (fear and sadness in depression, for example, exaltation and enthusiasm for manic delusions).

Historically, how has the role of emotions been defined and regarded in the therapeutic relationship, but also in the clinical practice of observing diseases? How did this question bring to light the need for an increasingly institutional dialogue between doctors, men of letters, philosophers and artists today with the emergence of the so-called "medical humanities"? 

What is the place of emotions today in the therapeutic relationship, when disclosing a diagnosis, giving a choice between several possible treatments, in the management of chronic diseases or the establishment of palliative care?

How are doctors and researchers confronted to the question of emotions nowadays? What does the injunction to show more empathy mean, and what are its limits?

Finally, have new practices or methods of communication been established to enable the identification and recognition of emotions within the therapeutic relationship - and so without necessarily falling into a caricatural opposition between a biomedical model of medicine, centered on treatment, and an alternative model, supposedly more "human" and centered on the idea of healing and affects?




Stevie TIERNEY -Art


 Stevie Tierney, a Nurse in Kansas City (Missouri), very kindly allowed us to show a few of her pieces in this conference. They are a way for her to incorporate and connect both of her passions, and to turn mental health disorders into paintings which contain symbolism and raw emotion, highlighting the importance of understanding these illnesses. She decided to merge her understanding of mental health and her own personal struggles with her passion for art and helping others. She went through a very detailed and thought out process when making these mental health pieces, using liquid, high-flow and solid acrylics. She thus created a series of paintings based off mental health illnesses, which you can find on her Etsy account MentalHealthAware. You can support her work by visiting her website and ordering prints of her paintings depicting Mental Illnesses on her Etsy Account.


TIERNEY, Stevie - Anger 


"The person is violently shaking from anger. They are unable to control their emotions and what is going on around them, screaming with rage. They see red and may even blackout, they have no control. The heart in the middle is meant to symbolize shaking as well, that being a big symptom. The hands are aggressive and tense, looking like they are coming out to hurt you".


TIERNEY, Stevie - Anxiety


"I used what my anxiety feels like as inspiration for this one. The eyes and the mouths, in the black cloud, are the social anxiety: they represent the fear of constantly being judged, talked about, laughed at, and watched. They are cartoons because our brain is our worst enemy, creating this reality in our heads that is not real. The lungs being squeezed by hands represent panic attacks: we cannot explain whether it’s ourselves causing these attacks or something internal. The eyes remain white because I can never focus in my anxious state, some people can black out. The arms have this appearance of melting because they can tingle and go numb with panic attacks and anxiety, tend to lose feeling in our hands. All the black spots building off the black cloud symbolize how our anxiety grows and builds off everything around us and our mind".

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