Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How motivational interviewing can relieve patients’ suffering

Jeff Kane, MD
Physician
July 27, 2015
Share
Tweet
Share

The acronym “MI” has traditionally meant myocardial infarct, or heart attack. Recently it’s taken on a new, more salubrious meaning: motivational interviewing.

A growing number of docs are practicing this technique, which amounts to listening to patients to help them recognize their internal sources of behavior. Boston’s NPR affiliate, WBUR, describes typical MI interventions in which doctors, instead of demanding that patients stop smoking or drinking or overeating, gently encourage them to get in touch with their reasons for pathogenic behaviors, a process which leaves them more likely to change.

This extends the purpose of medical listening. Usually taking a history is a search for clues to diagnosis. A patient’s narrative contains those clues, to be sure, but is also rich in social content, family stories, folklore, and additional random flotsam which the doctor needs to navigate around. MI offers docs a wider-angle lens. Now, in addition to listening for diagnosis, they can also catch motivational clues which can point a way to effective treatment.

But why stop there? We can use the technique to treat suffering itself.

Having facilitated cancer support groups for more than thirty years, I’ve come to the almost blasphemous conclusion that tumors don’t bother people much. Patients can experience pain, nausea, and other symptoms, but the bulk of their suffering comes from their own emotions. Fear, anxiety, depression, loneliness, confusion, and despair aren’t neurotic reactions, but normal, anticipatable concomitants of serious illness. But these emotions are treatable only if we listen for them.

I routinely ask people with cancer (and family members, too), “What bothers you about your cancer?” Sometimes they initially take offense, but when they realize I’m more sincere than impertinent, they seriously consider the question, and over days or weeks of conversation arrive at answers that become therapeutic.

“What bothers me? Well, it means I’m going to die.”

“What bothers you about dying? No, really.”

This is no easy issue, of course. It can take another week of cogitation.

“I can’t die yet. I have unfinished business.”

“Like?”

“Well, I’m estranged from one of my kids.”

“Do you want to do anything about that?”

This patient has now discovered something she can act on and consequently diminish her suffering.

ADVERTISEMENT

Of course, this style is a slight expansion of the medical mission. Maybe we docs aren’t restricted to simply diagnosing and treating illness. We can also be in the business of alleviating suffering.

Jeff Kane is a physician and is the author of Healing Healthcare: How Doctors and Patients Can Heal Our Sick System.

Prev

Physician success stories don't make it to the newspaper

July 27, 2015 Kevin 5
…
Next

What, exactly, does a "real doctor" look like?

July 27, 2015 Kevin 7
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
Physician success stories don't make it to the newspaper
Next Post >
What, exactly, does a "real doctor" look like?

ADVERTISEMENT

More by Jeff Kane, MD

  • Patient complaints prompt hospital to reevaluate doctor’s bedside manner

    Jeff Kane, MD
  • There’s no easy way out of the opioid epidemic

    Jeff Kane, MD
  • Turning doctors into technicians is a mistake

    Jeff Kane, MD

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • Physician Suicide Awareness Day: Where are the patients? 

    Jennifer M. Sweeney
  • Is physician shadowing immoral?

    David Penner
  • A love letter to patients

    Marcie Costello
  • Patients are not passengers

    Christopher Noll, RN, MSN

More in Physician

  • Why midlife men feel unanchored and exhausted

    Kenneth Ro, MD
  • How medicine reflects women’s silence

    Priya Panneerselvam, DO
  • Language doulas bridge care gaps

    Deepak Gupta, MD, Kaya Chakrabortty, and Yara Ismaeil
  • The myth of no frivolous medical lawsuits

    Howard Smith, MD
  • Divorced during residency: a story of clarity

    Emma Fenske, DO
  • A husband’s story of end-of-life care at home

    Ron Louie, MD
  • Most Popular

  • Past Week

    • The Silicon Valley primary care doctor shortage

      George F. Smith, MD | Physician
    • The ethical conflict of the Charlie Gard case

      Timothy Lesaca, MD | Conditions
    • Preserving your sense of self as a doctor

      Camille C. Imbo, MD | Physician
    • Understanding the hidden weight bias that harms patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The ethics of mandatory Tay-Sachs testing

      Sheryl J. Nicholson | Conditions
    • The geometry of communication in medicine

      Patrick Hudson, MD | Physician
  • Past 6 Months

    • Why you should get your Lp(a) tested

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Direct primary care in low-income markets

      Dana Y. Lujan, MBA | Policy
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • The flaw in the ACA’s physician ownership ban

      Luis Tumialán, MD | Policy
    • Stop doing peer reviews for free

      Vijay Rajput, MD | Education
  • Recent Posts

    • Why modern dentists must train like pilots [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why you need a GLP-1 exit plan

      Holli Bradish-Lane | Conditions
    • Why midlife men feel unanchored and exhausted

      Kenneth Ro, MD | Physician
    • How medicine reflects women’s silence

      Priya Panneerselvam, DO | Physician
    • Why not all ADHD generics are created equal

      Ronald L. Lindsay, MD | Conditions
    • Early Alzheimer’s blood test: Is it useful?

      M. Bennet Broner, PhD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The Silicon Valley primary care doctor shortage

      George F. Smith, MD | Physician
    • The ethical conflict of the Charlie Gard case

      Timothy Lesaca, MD | Conditions
    • Preserving your sense of self as a doctor

      Camille C. Imbo, MD | Physician
    • Understanding the hidden weight bias that harms patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The ethics of mandatory Tay-Sachs testing

      Sheryl J. Nicholson | Conditions
    • The geometry of communication in medicine

      Patrick Hudson, MD | Physician
  • Past 6 Months

    • Why you should get your Lp(a) tested

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Direct primary care in low-income markets

      Dana Y. Lujan, MBA | Policy
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • The flaw in the ACA’s physician ownership ban

      Luis Tumialán, MD | Policy
    • Stop doing peer reviews for free

      Vijay Rajput, MD | Education
  • Recent Posts

    • Why modern dentists must train like pilots [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why you need a GLP-1 exit plan

      Holli Bradish-Lane | Conditions
    • Why midlife men feel unanchored and exhausted

      Kenneth Ro, MD | Physician
    • How medicine reflects women’s silence

      Priya Panneerselvam, DO | Physician
    • Why not all ADHD generics are created equal

      Ronald L. Lindsay, MD | Conditions
    • Early Alzheimer’s blood test: Is it useful?

      M. Bennet Broner, PhD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How motivational interviewing can relieve patients’ suffering
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...