We often think of experience as a private mirror. That is, there are events in the world, and they are reflected in our private experience. A patient may thus experience individuals in a healthcare system as nurturing and helpful as opposed to cold and indifferent. This view is shortsighted in two related ways. First, we are not passive recipients of others actions toward us; we are active agents in the world – even as patients – and these activities affect how we experience others. The quality of experience depends on what we are seeking, and what role we are playing. For example, the experience of pain you might experience at a sharp blow to your head is not the same as that of a boxer in the ring. Likewise, the pain of a needle being stuck in your arm is quite different for a patient who fears pain and is trying to avoid it, than one who eagerly seeks a blood test. The way we participate in health systems will vitally color what and how we experience.
AS WE PARTICIPATE, SO DO WE EXPERIENCE
This brings us to the second flaw in the common assumption that experience is like a mirror. It is not simply that the way we participate colors our experience. But this participation does not take place in a vacuum. The quality of experience depends on the relationships in which we are participating. Consider again the pain of the boxer. He is not boxing alone, but participating in a traditional form of relationship. In the same way, when we approach health systems with fear and defensiveness, we are also participating in a particular social tradition. Similarly, the way one experiences the probing hands of a doctor – a formalized relationship - is far different than the same touches occurring in the hands of a partner’s embrace. In effect, we may say that experience vitally depends on our participation in relationships.
TOWARD RELATIONAL HEALTHCARE
In this light, the concern with patient experience shifts focus from the individual to the relationships of which the individual is a part. In effect, our sites turn to relational practices, and especially those practices that enhance the patient’s experience. Some of these practices are clear enough. We all know the positive impact of family relations that can lift the spirits and give meaning to the future. New innovations are also emerging on the scene. Programs in which patients are drawn into the treatment team – collaborating with physicians and nurses in their own care – are blossoming. Programs that increase the empathy of doctors for their patients, and patients for their doctors, are growing in numbers. Practices in which patients contribute to the education of physicians are inspiring. In all cases, there is an increasing sense that the best in healthcare grows from an awareness that "we are all in this together.”
A CONFERENCE ON RELATIONAL PRACTICES IN HEALTHCARE
For anyone wishing to know more, to explore the many potentials of a relational approach to healthcare, I would also like to recommend an upcoming conference Relational Practices in Health and Healthcare: Healing through Collaboration. It promises to be a lively, informative, and significant event.
This international conference will be held in Cleveland, Ohio at the new Global Center for Health Innovation, November 10-12, 2016. The conference is offered by the Taos Institute in collaboration with the International Institute for Qualitative Methodology, Alberta, Canada. The significance of relational practices will be underscored by a plenary offering from Jason Wolf, President of The Beryl Institute, and passionate champion of positive patient experience.
Kenneth Gergen is a Senior Research Professor at Swarthmore College and the President of the Taos Institute. He is internationally known for his writings on social construction and relational process, and their many applications to professional practice.