Patient-Clinician Eye Contact: Social Neuroscience and Art of Clinical Engagement

被引:27
作者
MacDonald, Kai [1 ]
机构
[1] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA
关键词
eye contact; social neuroscience; empathy; social anxiety disorder; oxytocin; amygdala; FACIAL EXPRESSIONS; BILATERAL AMYGDALA; NEURAL MECHANISMS; FEAR-RECOGNITION; GAZE DIRECTION; MIRROR NEURON; TO-EYE; MIND; OXYTOCIN; ACTIVATION;
D O I
10.3810/pgm.2009.07.2039
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Clinical encounters with patients are a form of social engagement. A critical and implicit component of meaningful engagement with patients is eye contact. Researchers in the rapidly growing, multidisciplinary field of social neuroscience have discovered a great deal about this "first-contact" aspect of human relating that is of direct and practical relevance to the practicing clinician. Findings reviewed in this article include aspects of the neurobiology of social attention, the role of certain neurochemicals (eg, serotonin, oxytocin) in eye contact, and the diagnostic importance of eye contact and gaze in various diagnostic entities. Clinically, these findings underscore the important role of eye contact in 1) establishing meaningful rapport; 2) supplying implicit information about a patient's emotional state; 3) providing diagnostic clues to common psychiatric disorders; 4) delivering impactful clinical messages; and 5) provisioning hope and embodied empathy. Current neuroscience research in this area highlights why mindful attention to this facet of social engagement is part of the repertoire of an effective, empathic clinician.
引用
收藏
页码:136 / 144
页数:9
相关论文
共 91 条
[1]   HLA class I and II genotype of the NCI-60 cell lines [J].
Adams, S ;
Robbins, FM ;
Chen, D ;
Wagage, D ;
Holbeck, SL ;
Morse, HC ;
Stroncek, D ;
Marincola, FM .
JOURNAL OF TRANSLATIONAL MEDICINE, 2005, 3 (1)
[2]   Impaired recognition of social emotions following amygdala damage [J].
Adolphs, R ;
Baron-Cohen, S ;
Tranel, D .
JOURNAL OF COGNITIVE NEUROSCIENCE, 2002, 14 (08) :1264-1274
[3]   Neural systems for recognizing emotion [J].
Adolphs, R .
CURRENT OPINION IN NEUROBIOLOGY, 2002, 12 (02) :169-177
[4]  
Adolphs Ralph, 2002, Behav Cogn Neurosci Rev, V1, P21, DOI 10.1177/1534582302001001003
[5]  
Baron-Cohen S, 2001, J CHILD PSYCHOL PSYC, V42, P241, DOI 10.1017/S0021963001006643
[6]   Another advanced test of theory of mind: Evidence from very high functioning adults with autism or Asperger syndrome [J].
BaronCohen, S ;
Jolliffe, T ;
Mortimore, C ;
Robertson, M .
JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY, 1997, 38 (07) :813-822
[7]   Mind does really matter: Evidence from neuroimaging studies of emotional self-regulation, psychotherapy, and placebo effect [J].
Beauregard, Mario .
PROGRESS IN NEUROBIOLOGY, 2007, 81 (04) :218-236
[8]   Listening to your heart: interoceptive awareness as a gateway to feeling [J].
Bechara, A ;
Naqvi, N .
NATURE NEUROSCIENCE, 2004, 7 (02) :102-103
[9]   Viewing facial expressions of pain engages cortical areas involved in the direct experience of pain [J].
Botvinick, M ;
Jha, AP ;
Bylsma, LM ;
Fabian, SA ;
Solomon, PE ;
Prkachin, KM .
NEUROIMAGE, 2005, 25 (01) :312-319
[10]   Imitation: is cognitive neuroscience solving the correspondence problem? [J].
Brass, M ;
Heyes, C .
TRENDS IN COGNITIVE SCIENCES, 2005, 9 (10) :489-495