Failure to recognize a need, such as that of being heard by the doctor (and not only), generates profound discomfort. Now the mechanisms are known
That sense of discomfort that one feels when other people have attitudes and behaviors towards us that hurt us has a solid neurobiological basis. Indeed, in these situations areas belonging to both the cognitive and the emotional and motor spheres are activated in the brain, as if one were preparing in some way for flight or attack, as if one perceives a threat to one’s psychophysical integrity. These networks, which are activated when the behaviors of others hurt our sensitivity, are also the same ones that are activated when physical pain is perceived, so s
i can say that hostile or unsupportive words and attitudes can really hurt.
Research
what emerges from an innovative experimental research carried out by the Giancarlo Quarta Onlus Foundation of Milan for some time engaged in studies in this sector, considered increasingly important within the clinical relationship. The research, called FIORE 2 (Functional Imaging of Reinforcement Effects), created in collaboration with the University of Padua and the Padua Neuroscience Center (Pnc). It follows a previous trial he had measured the cerebral effects of a communication that was instead to be considered positive and which met people’s expectations and needs (FIORE1) The FIORE 2 research was carried out on healthy volunteers, 30 people of both sexes and aged between 19 and 33 years, subjected to brain imaging investigations carried out with Functional Magnetic Resonance.
How neuronal networks are activated
The researchers looked at the activation of different neuronal networks while the subjects had to identify with some cartoons relating to social relationships characterized by positive, neutral or negative stimuli. An example is the image of a person who is getting on the train with a heavy suitcase: the individual behind her snorts and does not help (negative reinforcement), stands still and waits (neutral attitude), smiles and helps to load the suitcase ( positive reinforcement). In addition to undergoing the MRI, the volunteers filled out two evaluation tests of personality and affectivity: the BFQ – Big Five Questionnaire and the QDF – Questionnaire on Daily Frustrations.
During exposure to an “antisocial” situation we observed variations in local brain activation and functional connectivity between different areastherefore of the synchrony between different brain regions explains Fabio Sambataro of the Department of Neuroscience of the University of Padua. In particular, the superior temporal gyrus, the secondary visual areas, the motor areas, the thalamus and the prefrontal dorsomedial cortex are activated more, while connectivity between temporal regions decreasesie, on the other hand, that of the motor and prefrontal regions increases with post-central areas, insula and anterior cingulate.
The recognition of antisocial behavior
a complex phenomenon, but it can be schematically divided according to a temporal order. We can recognize different phases that correspond to the recruitment of specific circuits, adds Sambataro. First of all, the “recognition of the situation of social interaction” occurs, through the superior temporal cortex, which belongs to the circuit of the theory of mind, the ability to understand the behavior of others. The “negative affective response” followsin which the structures of the limbic system and those of the thalamus are activated and modify their connectivity with the circuit of salience – that is, of the importance given to the event – of pain, but also that of the motor response. Finally, the “motor activity control response” is activated: the prefrontal cortex controls the activity of the motor cortex itself, inhibiting possible impulsive behaviors.
Immediate reaction
Failure to recognize a person’s needs therefore represents a real violation of the social relationshipan even more evident and important phenomenon if that relationship between doctor and patient. The result is an immediate reaction that is emotional, psychic and physicalwith the activation of an important alarm system, which involves a neural circuit similar to that of physical pain, says Sambataro. If the need-response misalignment persists, the relationship can lose meaning and even come to undermine self-esteem. making the relationship itself useless, if not downright harmful. The doctor should always find the time and the ways to listen to the patient with her spaces and times, accepting his need for empathy, recognition, in order to guarantee a relationship that is truly therapeutic.
The positive effects
A classic study on the positive effects that correct and careful communication with patients can have who are heading towards the difficult period of the end of life and with their families that published a few years ago in the New England Journal of Medicine by a group of researchers led by Alexandre Lautretteanesthetist and resuscitator of the Center Jean Perrin in Clermont-Ferrand (France). The study, a randomized and controlled trial, has shown that a proactive and attentive approach to communicating with patients and family members can reduce the symptoms of anxiety and depression in the latter. as well as the risk of developing post-traumatic stress disorder following the death of their relative. The family members of the group in which the structured communication modality was experimentally inserted had greater opportunities to discuss the patient’s wishes and the difficult choices they made, to express their emotions, to alleviate the feelings of guilt and to understand what were the objectives of the cures, not always immediately understandable.
June 7, 2022 (change June 7, 2022 | 11:22)
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