What makes the patient-doctor relationship therapeutic? Exploring the connexional dimension of medical care

Ann Intern Med. 1988 Jan;108(1):125-30. doi: 10.7326/0003-4819-108-1-125.


Physicians do not receive from the medical model the same explicit guidance in relating to their patients as in making diagnoses and prescribing pharmacologic and other treatments. To meet this need, we offer a framework for expanding the model. Therapeutic contact takes place within a connexional, or transpersonal, dimension of human experience, within which basic human needs for connection and meaning are met. Although seldom explicitly recognized, connexional experience is basic to medical care. Awareness of this dimension of experience leads clinicians to appreciate that establishing a therapeutic relationship is one of the principal goals of medical practice. It also reframes the doctor's task to make clinical uncertainty more tolerable and situations in which there is no appropriate biomedical response (such as care of the terminally ill) less frustrating and more fulfilling.

Publication types

  • Historical Article

MeSH terms

  • History, 15th Century
  • History, 16th Century
  • History, 17th Century
  • History, 20th Century
  • History, Ancient
  • History, Medieval
  • Metaphysics
  • Philosophy, Medical*
  • Physician-Patient Relations*
  • Social Values
  • Stress, Psychological