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What level of doctor-patient relationship do you want? 


  1. Transactional. Something is broken and needs to be fixed. The doctor provides the remedy. Manualised treatment may be the best example of this approach to therapy.
  2. The focus is not just on what’s broken but is a process where the doctor provides things the patient can also do to remedy the problem. A certain diet, a list of “dos” and “don’ts.’
  3. The doctor helps the patient reflect on why they behave as they do. The doctor becomes a coach to the patient, co-creating environments where the patient makes the changes himself.
  4. The doctor and patient enter into a relationship of mutual influence and vulnerability, each opening themselves to discovery. This is a mutual form of seeing with the heart, of presence.

Which of these levels of doctor-patient relationship do you want? Research shows that most would opt for the third and fourth levels of relationship although what we collectively offer seems to be more on levels one and two…




What we now are learning with the convergence of science, medicine and spirituality is that seeing with the heart is indeed what heals. And to see with the heart requires an opening of the heart to others and ourselves. What is required is an experience of connectedness, real sensing and presencing, a rediscovering of the sacred space between people in “I-Thou” relationships, rich in life energy with the potential for connection.

In the end, the success of our interventions in therapy depends on the inner condition of the intervener. That’s far more important than techniques or strategies for change. In short, the fundamental insights of twentieth-century physics have yet to penetrate the world of medicine and therapy: relationships are more fundamental than things.

To paraphrase physicist Bohm again, the imperative of therapy is to evolve our awareness, so that it might naturally become more whole, more in line with our connectedness to others.

Einstein summarized this when he said: “Our task must be to widen our circle of compassion to embrace all living creatures and the whole of nature in its beauty.” In this way, we will not just see the world as it is but as we are, for no human being, including psychotherapists, have a privileged view of reality.

Martin Buber said: “Freedom and destiny are solemnly promised to one another and linked together in meaning.” But, as Native American teachers have said, often the longest road we will ever walk is the sacred journey from our head to our heart.

Written by David J. Powell, Ph.D., 10 April 2007.
Retrieved 6 August 2008 from