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The alliance between homeopath and patient is a critical one. The homeopath, by way of the homeopathic principles, requires of the patient to share, reveal, and convey in explicit detail the nature of what ails him [5]. The patient needs of the homeopath, in order to feel secure and prepared to share such intimate information, that he provide a trusting and comfortable space in the consultation.

The homeopathic consultation is one that differs to that exercised in conventional medical practice. It is dominated by the patient and not by the practitioner. The contrary is customary in the encounter between general practitioner and patient. Here the patient assumes a passive role while the GP identifies what ails the patient and proposes a medicinal intervention [1]. The homeopathic patient-practitioner union is reliant on what the patient perceives as symptoms of the disease in his totality, and as such is therefore patient-led. This fact alone does not suffice to provide a patient with trust and ease in the consultation. Such sensitive union requires other elements or ‘tools’ in order to ascertain to the patient that his encounter with the practitioner is a safe and comfortable space. Person-centered qualities may facilitate what is necessary to establish such features in this union.

The ‘person-centered approach’ was first described and explained as such by Carl Rogers, one of the initiators of the humanist approach to psychology [2]. In the field of psychology and counselling, the focus of the practitioner is on activating the patients most inert resources in order for growth to be achieved. The believe underlying this concept is that the patient knows best of his own needs. The practitioners sole role is to aid the patient in accessing or recognizing these resources [3] [4]. Homeopaths can, following the principles underlying homeopathic practice, as is outlined in the Organon [5], borrow aspects from this approach in order to facilitate a comfort-zone to the patient, in the consultation. Yet, ‘patient-centered’ does not only mean that the focus is on the patient, his descriptions and narrations, but actually emphasizes much more on the practitioners presence within the therapeutic encounter [6] [7] [8] .

Of the 6 core conditions that inform the person-centered approach, in application to a homeopathic context, the following descriptions are useful to the development of a functioning therapeutic relationship:

The practitioner has to be there, qualitatively, with the patient   in the consultation. [6] [7] [8]. This he may express by being empathic and understanding towards the patient [7]. A form of mutual trust [4] of practitioner and patient aids in abolishing discomfort and may provide security in the therapeutic union. This trust may be further deepened by the practitioners expression of acceptance and non-judgement towards the patient and his case. Termed the ‘unconditional positive regard’, this requisite is an acknowledgement of the fact that every individuals actions are grounded on his very own personal reasons [9]. A practitioner may further deepen this trust if he is genuine toward the patient and if this is conveyed by the practitioners own authentic expressions arising from the patients descriptions in the consultation. The patient is then believed to be congruent towards the patient [10].

These attributes of the homeopathic practitioner may serve to create the ‘trusted zone’ for the patient, where he feels comfortable enough to disclose his ailing state in such detail as is relevant for the case-taking. Only if the idiosyncrasies, the most individual characteristics of the disease in the patient, by way of the patients own expressions, are reported, can the practitioner select the best matching remedy to suit the patients case [5]. A relationship that lacks trust and comfort may suffer of misinterpretation of the case-taking as the reported descriptions and expressions may have failed to inform the case sufficiently. The elements, native to the person-centered approach, are to an extent natural to the homeopathic patient-practitioner encounter, but the awareness of a patient-centered attitude that is expressed toward a patient, may facilitate its use as a tool to promote the creation of a trusted and comfortable union in the consultation.

References:

[1] Hartog, C. (2009) Elements of effective communication-Rediscoveries from homeopathy [online] Patient education and counseling Vol.77, pp.172-178, article from Elsevier, last accessed 02 October 2010

[2] Casemore, R. (2006) Person-centered Counseling in a Nutshell London: Sage publications Ltd.

[3] Pörtner, M. (2000) Trust & Understanding: The person-centered approach to everyday care for people with special needs Ross-on-Wye: PCCS Books.

[4] Wilkins, P. (1999) The relationship in person-centered counseling. Chapter 3 IN Feltham, C. (Ed.) (1999) Understanding the counseling relationship London: Sage Publications Ltd.

[5] Hahnemann, S. (1974) Organon der Heilkunst (2.Auflage) 6B Heidelberg: Karl F. Haug Verlag.

[6] Lane, R., Koetting, M. & Bishop, J. (2002) Silence as communication in psychodynamic psychotherapy [online] Clinical psychology review Vol.22, pp.1091-1104, article from sciencedirect, last accessed 23 September 2010

[7] Nacht, S. (1963) The non-verbal relationship in psycho-analytic treatment [online] The international journal of psychoanalysis Vol.44, pp.334-339, article from PEP Web, last accessed 04 October 2010

[8] Freshwater, D. & Stickley, T. (2006) The art of listening in the therapeutic relationship [online] Mental health practice Vol.9, No.5, pp.13-18, article from Ebscohost, last accessed 04 October 2010

[9] Tolan, J. (2003) Skills in person-centered counseling and psychotherapy London: Sage publications Ltd.

[10] Merry, T. (1999) Learning & Being in Person-Centered Counseling Ross-on-Wye: PCCS Books, pp.85-117.

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