Psychoanalysis is a method that treats emotions through communication. The purpose of psychoanalysis is to gain insight into an individuals’ perspective and how their view on their individual situations may affect their feelings, behaviors, and relationships¹. Although it tends to be a controversial discipline and is often argued that it is not a science², there is one Freudian concept that remains fundamental: there is a dominant effect of the unconscious on one’s feelings and actions¹. Understanding this concept may be an important avenue to teach the skill of empathy, as empathy is an affective process that includes feelings and responses related to behaviors and beliefs³.

Before continuing, it is important to note the difference between psychoanalysis and psychotherapy. Psychoanalysis emphasizes the importance of understanding the unconscious motivations to a patient’s feelings and views on different situations, whereas psychotherapy focuses on current symptoms and how to cope with and reduce them¹. 

Applying the theories of psychoanalysis into modern medicine to teach empathy may reduce the Cartesian dualism that riddles the medical field today. Cartesian dualism is the perspective that the mind and body are two separate entities, which results in many physicians omitting psychosocial factors when investigating components that influence physical disease. If these factors are considered, they are considered only fleetingly or are only investigated for the sake of reducing their negative impacts⁴. In philosophy, Cartesian dualism is argued by Damasio, a neurologist, who stated that the dualist separation of mind and body is incorrect and that the function of emotion is what navigates an individual’s decision making⁵.

Damasio explained that consciousness is developed through three aspects: emotions, feelings, and feelings of feelings. In other words, he states that emotions are a collation of unconscious neural responses to different external situations. Therefore, emotional reactions are caused by tangible environmental changes, resulting in a feeling when an individual becomes aware of such changes. Once this feeling becomes conscious, it causes an individual to feel the feeling, producing a decision to act or not act⁶. Using the theory explained by Damasio, the adaption of psychoanalysis by physicians can be used as a means to train future doctors in the skill of empathy by demanding physicians to understand the perspective of the patient. It can teach physicians how to grasp a patient’s unconscious thought¹ as a way to more precisely comprehend a patient’s concern and a way to gain additional information that can aid in a more correct diagnosis. This empathy can further allow a physician to provide information in a way that involves the patient, focusing on patient-centered care³. 

A study done by Loffler-Stastka et al. made an interesting suggestion as a way to incorporate psychoanalysis into medical education to increase empathy within future physicians. They suggest cognitive empathy training, which focuses on communication skills with standardized patients³. Although, this is already a practice with many medical schools, a structured course focusing on empathy through the lens of psychoanalysis can increase a student’s ability to recognize and empathize with feelings, as empathy requires communication. Empathy must be focused on as a skill that needs to be trained, instead of just telling students that they need to be empathetic. 

References

1. Psychoanalysis: Theory and treatment. Harvard Women’s Health Watch. Published: Dec 2006. https://www.health.harvard.edu/newsletter_article/Psychoanalysis_Theory_and_treatment
2. Paris J. (2017). Is Psychoanalysis Still Relevant to Psychiatry?. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 62(5), 308–312. https://doi.org/10.1177/0706743717692306
3. Loffler-Stastka, H., Felcitas, D., Parth, K., Preusche, I., Bukowski, X., Seidman, C. (2017). Empathy in Psychoanalysis and Medical Education – what can we learn from each other? BMC Medical Education, 17(74). 
4. Jacobs, M. S. (2006). Working in American Medicine: Reflections of a Psychoanalyst. Medical Realities and Psychological Experience: Bridging the Great Divide. 
5. Glasnović, A., Babić, G., & Demarin, V. (2015). Psychoanalysis has its place in modern medicine, and neuropsychoanalysis is here to support it. Croatian medical journal, 56(5), 503–505. https://doi.org/10.3325/cmj.2015.56.503
6. Bosse, Tibor; Jonker, Catholijn M.; Treur, Jan (2008). “Formalisation of Damasio’s Theory of Emotion, Feeling and Core Consciousness”. Consciousness and Cognition. 17 (1): 94–113. CiteSeerX10.1.1.77.4458. doi:10.1016/j.concog.2007.06.006