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Feature Article Psychiatry and psychology
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Difficult doctor–patient interactions: applying principles of attachment-based care

Kay Wilhelm, Tad Tietze

Understanding a patient’s attachment style allows prediction of likely patterns of interaction in clinical settings and helps in tailoring an overall treatment approach to suit the patient’s style. This attachment-based care approach is particularly useful in the context of difficult doctor–patient interactions.

Key Points
  • Difficult doctor–patient interactions are common and can be a barrier to effective care, with negative emotional consequences for both patient and doctor.
  • Attachment theory can help us understand such interactions as relational styles that both patient and doctor bring to clinical settings.
  • Understanding difficult interactions in terms of a social relationship helps shift attention away from a pejorative and unproductive focus on the ‘difficult patient’.
  • Adults with insecure attachment styles (‘preoccupied’, ‘dismissing’, ‘fearful’ and ‘disorganised’) are more likely than those with a ‘secure’ style to have problems in the context of illness and stress.
  • Attachment style can help predict potential problems in the clinical interaction.
  • Simple interventions can address specific difficulties in the doctor– patient interaction.

    Picture credit: © Urfinguss/iStockPhoto.

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