How to Tell Cancer Patients

How to tell patients they have cinecr is; in important question in cancer eure. The question provokes distress in physicians, and a railure in relating the diagnosis may arrest patients' process of coping with anxiety and reduce their subjective well-being. This contribution to a theory of communicating about the diagnosis is empirically based on an earlier study in which patients with malignant brain tumors were interviewed and is theoretically based on contemporary object-relational psychoanalysis. The authors propose that a beneficial physician-patient encounter can be viewed as characterized by die acknowledgement of the physician as an unconscious protection against death and as a facilitating environment for the patient's reconstructive process. The implications of these propositions are discussed. The authors also propose that the transference from the child-parent relationship to the patient-physician relationship enables physicians to use introspection as a means to improve their skillfuhicss regarding “How to tcM.” Thus, introspection may provide physicians with guiding knowledge grounded in themselves.