Different approaches to understanding patients in general practice in Denmark: aqualitative study
Mentalization involves being aware of and absorbing and understanding mental conditions in oneself and others. Many mental processes are involved – not only thoughts and emotions, but also needs, wishes and fantasies. In all social interactions, for example in the relation between patient and doctor, the ability to perceive and interpret the intentions, impressions and emotions of oneself and others is central.
This definition is by Bengt Mattsson, professor emeritus at the unit for general medicine, University of Gothenburg, from his article “Om läkares olika fallenhet att relatera till patienter”. The title can be roughly translated as “On doctors’ different ways of relating to patients”.
The study he describes found four different ways of relating to patients, many of whom had mental problems:
Mentalizing: Emotionally engaged, welcoming attitude, accepting of differences, curious and intent on understanding thoughts, emotions and impressions. Often able to connect with the patients’ situation from a broad overview.
Limited mentalization ability: Interested in the problem but could not always see a connection with other life situations. Limited interest and curiosity, uneven seriousness and respect for the patient.
Rejecting: Limited patience, could dismiss the patient’s perspective, did not reflect much over their own role in the interaction. Might scoff at patients with mental problems.
Biomedical: Focus on categorization, diagnostics, rating scales and medical treatment. The doctors were neutral and did not wish to be involved in psychological circumstances. The narratives of patients were considered information to be fitted into a biomedical frame.