8 Elements of social psychology and
their role in activity of a doctor
L/O/G/O
Contents
1
Definition, meaning and
function of dialogue,
structure of dialogue
2
Communicative side
3
Interactive side
4
Perceptive side
www.themegallery.com
• In the professions connected to interaction
"person to person", orientation to another as
equal participant of interaction is important,
especially the ability to humanistic, moral reaction
in professional work of the doctor. As the object
of research and the subject of interaction is the
person, and character of knowledge is applied .
• Bases of psychological knowledge are necessary for
medical workers as they promote: to attentive and
interested attitude of people to each other in treatmentand-prophylactic activity; to mutual trust arising on this
basis; abilities to partnership, empathy, and hence, to
mutual understanding.
• The last is necessary because the medical worker
and the patient together solve the same task preservations of health, prevention and treatment of
diseases that assumes their cooperation and
interaction, i.e. active dialogue.
www.themegallery.com
• «The doctor can seldom cure, he can facilitate more
often, but he must always console», - the ancient
speak. Competently established psychological contact
to the patient helps to collect more precisely the
anamnesis, to receive fuller and deep representation
about the patient. If there is no psychological contact
with the patient, probably, he will not adhere to
medical recommendations and purposes.
www.themegallery.com
• In psychology dialogue is the process
including transfer and information interchange,
interaction and mutual understanding of
people in developed system of public relations
(G.M.Andreeva, 1975; R.K.Novikova, 1977)
www.themegallery.com
Dialogue is studied from three points of view:
1
Dialogue as the factor of formation of
the person
2 Dialogue is studied as means of increase
of efficiency of work and training
3
Dialogue is studied as the specific
phenomenon
www.themegallery.com
Questions
•
•
•
•
1) Give a definition to the notion
“dialogue”
2) From what points of view is
dialogue studies?
www.themegallery.com
Structure of dialogue
• Taking into account complexity of dialogue, it
is necessary to designate its structure so that
the analysis of each element was possible.
G.M. Andreeva suggests to characterize
structure of dialogue by allocation in it of three
interconnected parties (sides): communicative,
interactive and perceptive. Schematically the
structure of dialogue can be presented as
follows:
www.themegallery.com
Structure of dialogue (G.М. Andreeva)
dialogue
communication
interaction
Social
perception
www.themegallery.com
Communicative side of dialogue
• The communication in the narrow sense will consist in
information interchange, in this case between the doctor and
the patient.
• The information is not only transferred, but also is formed,
specified and develops. The special role for participants of
dialogue is played with the importance of the information.
• In structure of communicative process there are the following
elements:
• А) Communicator - the subject transmitting the information;
• B) The recipient or communicant - the subject accepting the
information and interpreting it;
• C) A communicative field - a situation as a whole in which the
information can be transferred;
• D) Actually the information;
• E) Channels of the communications - means of transfer of the
information (verbal and nonverbal).
www.themegallery.com
• In conditions of human communications there can be
communicative barriers because of an accessory to various
social, age groups, owing to individual psychological features.
• Distribution of the information occurs through the original filter of
"trust" and "mistrust". Due to the filter a trustworthy information
can be not accepted, and false - accepted.
• Set of the means assisting to acceptance of information and
weakening action of filters, name fascination (A.A.Brudniy). They
are: musical, color support of speech and so forth.
www.themegallery.com
Nonverbal dialogue
• The information can be transferred not only by means of speech,
but also by means of all nonverbal behaviour including sights, a
look, poses, an interpersonal distance, intonation of a voice and
so forth. And visual contact and a pose frequently play more
important role, than speech.
• So a sight of the interlocutor expresses interest to conversation.
The running sight speaks about boredom or about desire to
speak (if only it does not express fear or feeling of fault). A
steadfast sight, it is direct in eyes to the interlocutor, it is
frequently perceived as aggression. However function of a sight
depends on type of culture.
www.themegallery.com
Nonverbal dialogue
www.themegallery.com
www.themegallery.com
Nonverbal communication
• Feelings are expressed by body gestures. So the
person shows openness if he faces with another man.
Hostility is usually shown by pressure of a body, and
sympathy in a relaxation of a body and an inclination
forward.
• The touch, voice in different cultures also are of great
importance. So the quiet voice promotes removal of a
pressure, and the "excited" voice is perceived as
aggression.
www.themegallery.com
According to Mehrabian (1972)
Face expression
55%
70
%
7%
38%
Word meaning
How words are
pronounced
www.themegallery.com
Questions
• 1) Name the structure of dialogue
according to Andreeva.
• 2) What do we understand under
the communicative side of dialogue?
• 3) What elements and structures of
communicative side do you know?
• 4) In what cases can a communicative barrier
occur?
• 5) What do we refer to non-verbal
communication?
www.themegallery.com
Interactive side of dialogue
• interaction consists in the organization of interaction
between participants.
• Different kinds of interaction:
• - Cooperation and a competition;
• - Coordinated interaction and disputed;
• - « Assisting behaviour », designed to the aid of
anothers and behaviour "loosening" joint activity.
• The professional - physician (as well as professional teacher) should own skills of behaviour of the leader,
and be capable to dialogical, nonmanipulative
dialogue.
• Conflict in interactive side of dialogue occupies a
special place.
www.themegallery.com
What is conflict - understanding
conflict
• There are different ways to come with a definition of
conflict. When speaking of conflict, what would
immediately come into mind would most likely be how
differences and disagreements make such an
occurrence to spring up. Having that, let us have that
question again, for the purpose of a more
comprehensive discussion.
www.themegallery.com
What is conflict - understanding
conflict
• Hence, what is conflict? It can be described as a
disagreement among groups or individuals
characterized by antagonism and hostility. This is
usually fueled by the opposition of one party to
another, in an attempt to reach an objective different
from that of the other party. The elements involved in
the conflict have varied sets of principles and values,
thus allowing such a conflict to arise.
www.themegallery.com
Conflict Management Styles
• Considering the fact that we as individuals have
different points of view, there will always be instances
when misunderstandings will occur among us. With
the arising of these intractable conflicts comes the
need for conflict management. Even in seemingly
ordinary situations, conflict may be rooted by other
non-apparent reasons. Understanding the other sides
of the issue would allow those involved to come up
with an ideal resolution to the problem. In dealing with
conflict, there are conflict management styles to be
followed. The Thomas-Kilmann Conflict Mode
Instrument, which is an assessment used globally in
conflict handling, specifies five strategies used to
address conflict. They are as follows:
www.themegallery.com
Accommodating
• Accommodation involves having to deal with the
problem with an element of self-sacrifice; an individual
sets aside his own concerns to maintain peace in the
situation. Thus, the person yields to what the other
wants, displaying a form of selflessness. It might come
as an immediate solution to the issue; however it also
brings about a false manner of dealing with the
problem. This can be disruptive if there is a need to
come up with a more sound and creative way out of
the problem. This behavior will be most efficient if the
individual is in the wrong as it can come as a form of
conciliation.
www.themegallery.com
Avoiding
• In this approach, there is withdrawal from the conflict.
The problem is being dealt with through a passive
attitude. Avoiding is mostly used when the perceived
negative end outweighs the positive outcome. In
employing this, individuals end up ignoring the
problem, thinking that the conflict will resolve itself. It
might be applicable in certain situations but not in all.
Avoidance would mean that you neglect the
responsibility that comes with it. The other individuals
involved might think that you are neglecting the
problem. Thus, it is better to confront the problem
before it gets worse.
www.themegallery.com
Collaborating
• Collaborating aims to find a solution to the conflict
through cooperating with other parties involved.
Hence, communication is an important part of this
strategy. In this mechanism, effort is exerted in
digging into the issue to identify the needs of the
individuals concerned without removing their
respective interests from the picture. Collaborating
individuals aim to come up with a successful
resolution creatively, without compromising their
own satisfactions.
www.themegallery.com
Competing
• Competition involves authoritative and assertive
behaviors. In this style, the aggressive individual
aims to instil pressure on the other parties to
achieve a goal. It includes the use of whatever
means to attain what the individual thinks is right.
It may be appropriate in some situations but it
shouldn’t come to a point wherein the aggressor
becomes too unreasonable. Dealing with the
conflict with an open mind is vital for a resolution
to be met.
www.themegallery.com
Compromising
• Compromising is about coming up with a resolution
that would be acceptable to the parties involved. Thus,
one party is willing to sacrifice their own sets of goals
as long as the others will do the same. Hence, it can
be viewed as a mutual give-and-take scenario where
the parties submit the same amount of investment for
the problem to be solved. A disadvantage of this
strategy is the fact that since these parties find an
easy way around the problem, the possibility of
coming up with more creative ways for a solution
would be neglected.
www.themegallery.com
• Given the different conflict management
styles, you might be thinking of the one style
that would suit you the most. It is important to
note that the strategy involved in coming up
with a resolution is relative to the kind of the
problem.
www.themegallery.com
Types of interpersonal dialogue
• There are three various types: an imperative,
manipulation and dialogue.
www.themegallery.com
Imperative dialogue
• – an authoritative, directive form of influence on the
partner with the purpose of achievement of control
over his behaviour and internal installations,
compulsion to certain actions or decisions. In this case
the partner on dialogue is examined as an object of
influence, acts as "passive" side. Feature of an
imperative is the ultimate goal of dialogue compulsion of the partner - is not veiled. Instructions
and requirements are used as means of influence.
www.themegallery.com
Imperative
• It is possible to name the whole group of social activity
where use of an imperative dialogue is quite justified
both with target, and with ethical points of view. In
professional work of the doctor the given type of
dialogue takes place when the doctor, adhering
models of interaction with the patient, directively
appoints the certain medicines and course of
treatment.
www.themegallery.com
Manipulation
• a widespread form of interpersonal dialogue supposing
influence on the partner on dialogue with the purpose of
achievement of the latent intentions. Manipulative
dialogue assumes objective perception of the partner on
dialogue which is used by the manipulator for
achievement of his purposes. Also manipulative dialogue
has a purpose to achieve control over behaviour and
ideas of other person. Radical difference is that the
partner is not informed on the true purposes of dialogue;
they either simply disappear from him, or are substituted
by others.
www.themegallery.com
Manipulation
•
•
•
•
Ways of manipulative behavior:
- choose the moment of giving information;
- subthreshold giving of information.
Concealment of manipulative influences. Manipulation
can be ascertained two kinds of concealment:
concealment of the fact of manipulative influences
and/or concealment of intentions of the manipulator. In
this case the task of concealment is solved so
cardinally, that the presence of influence can be found
out only with the help of the special equipment.
www.themegallery.com
Manipulation
• Sphere of allowed manipulation is business and
business relations in general, a policy(politics),
advertising, sphere of ideology. A symbol of such type of
relations for a long time became the concept of dialogue
of D.Karnegi and his numerous followers. It is widely
distributed manipulative style of influence on partners on
dialogue and in the field of propagation.
• At the same time possession of means of manipulative
influences on other people in business sphere is known,
that, as a rule, the person carries such skills to other
areas of the mutual relations. The relations constructed
on love, friendship and mutual attachment strongly
"suffer" from manipulation. Destruction of such
communications and substitution by others are
inevitable.
www.themegallery.com
Manipulation
• In manipulative process the partner is perceived not as
a complete unique person, but as a carrier of the
certain properties which are "necessary" to the
manipulator. So, it is important, that his kindness can
be used, and so on.
• However, the person who has chosen as basic this
type of the attitude to anothers, in result frequently
becomes a victim of own manipulations. He also starts
to perceive himself fragmentary, passes to
stereotyped forms of behaviour, is guided by false
motives and the purposes, losing a string of own life.
www.themegallery.com
• Comparison of imperative and manipulative forms of
dialogue allows to reveal their deep internal similarity.
Having united them together, it is possible to
characterize them as various kinds of monologic
dialogue. The person, considering another as object
of the influence, as a matter of fact communicates with
itself, with purposes and problems, not seeing the true
interlocutor, ignoring him.
• As real alternative to such type of attitudes between
people the dialogical dialogue allows to proceed
from the egocentric installation fixed on to installation
to the interlocutor, the real partner on dialogue.
www.themegallery.com
Dialogue
• Dialogue is equal subject subject dialogue which has
as an object mutual
knowledge, self-knowledge
and self-development of
partners on dialogue.
• Dialogue forms differently
than monologic dialogue.
www.themegallery.com
Questions
•
•
•
•
1) What do you understand under
the interactive side of
communication?
2) Name three main types of interpersonal
dialogue.
• 3) What main signs of manipulation do you
know?
• 4) In what spheres manipulation can be met
more often?
• 5) Which form of communication is the most
preferable in medicine?
www.themegallery.com
Immutable rules of mutual relations:
• Psychological adjust on an actual condition of the
interlocutor and own actual psychological condition. In
this case there is a principle « here and now », in view
of those feelings, desires and a physical condition,
which partners test at present;
• ·
nonvalue perception a partner’s individual,
aprioristic trust to his intentions (a principle of trust);
www.themegallery.com
Immutable rules of mutual relations:
• Perception of the partner as equal, having the right on
own opinion and own decision (a principle partneship);
• ·
The maintenance of dialogue common truths and
dogmas, and problems and unresolved questions (a
principle problematization maintenances of dialogue)
should be not;
• ·
A principle of personification of dialogue conversation on its own behalf, without the reference
to opinions and authorities, presentation of the true
feelings and desires.
www.themegallery.com
• For social psychology next ways of influence are
traditional: infection, suggestion, belief.
• Support, active hearing, reflection of feelings of the
partner, nonvalue judgements, understanding of
nonverbal behaviour of another, "I-statements" - base
communicative skills of the expert of the professional
at dialogical dialogue.
• The Swiss writer of XVIII century Lafater wrote: « you
want to be clever - learn to ask reasonably, to listen
attentively, to answer calmly and stop talking, when
you have nothing to tell more ».
www.themegallery.com
Rules of effective understanding and
studying of interlocutor
• - Listen more and speak less, "do not push" him to
discuss questions about which he should speak;
• - Aspire to react to individual-significant information
connected to needs(requirements) and interests of the
partner first of all;
• - Aspire to react to feelings and emotional conditions
of the partner.
www.themegallery.com
Perceptive side of dialogue
• (lat., perceptio – perception) – in dialogue as process
of perception by partners each other and an
establishment of a certain level of mutual
understanding.
• Perceptive side of dialogue means a process of
perception and knowledge each other partners on
dialogue and establishments on this basis of mutual
understanding. A problem of therapy from the point of
view of influence of the doctor on consciousness of the
patient is to improve of his ability to conscious
purposeful management of mental self-control, to
active counteraction of illness.
www.themegallery.com
• Mutual understanding can be interpreted as: а)
understanding of the purposes, motives, installations
of the partner, б) acceptance, division of these
purposes and installations that lead to an
establishment of special relations: the affinity
expressed in feelings of sympathy, friendship.
• In dialogue it is necessary to take into account, as the
partner understands your needs(requirements),
motives, installations.
www.themegallery.com
Techniques of social perception
•
• Identification - likening of to another. It is one of the
simplest ways of understanding of other person.
• Identification is closely connected to empathy which
also is defined as a special way of understanding of a
person. Thus the empathy assumes not rational
judgement of a problem of other person, and the
aspiration and ability emotionally to respond to his
problems.
• Reflection - comprehension by the individual of how
he perceives the partner on dialogue.
www.themegallery.com
• The perception of other people depends on how we
"classify" them therefore stereotypes of perception are
formed. Stereotypes generate a conditional and
simplified representation about other people. They are
formed depending on what group we belong, generated
by mastering of stereotypes of parents, teachers, friends,
introduced by mass media. Education, mutual contacts,
approachement of groups - promotes change of
stereotypes.
• The stereotype arises on a basis enough the limited last
experience, as a result of aspiration to build conclusions
on the basis of the limited information. However the main
problem is made not with the stereotype, but with
installation forcing us to adhere this or that behaviour.
www.themegallery.com
Installation
• Installation has three measurements: cognitive,
affective and behavioural. Cognitive includes opinions
and the belief allowing us to judge that is true,
plausible or possible. Affective measurement makes
positive or negative emotions connected to these
belief and which focus our actions. Behavioural
measurement of installation assumes a reaction of a
person corresponding to his belief and experiences.
• Installations get its final form between 12 and 30
years of a life. After that installations vary hardly. It is
necessary to distinguish the central installations which
form a nucleus of system of belief, and installations
peripheral, playing a smaller role in social adaptation.
www.themegallery.com
At perception people of each other there are
a number of effects:
• effect of an aura ("haloeffect"), effect of novelty and
primacy, effect or the phenomenon of stereotypification.
• effect of an aura - the information on the person is
imposed for that image which already has been created
beforehand. This aura prevents to see the valid features
for the present moment and display of object of
perception.
• effect of primacy and novelty concerns the importance of
a certain order of presentation of information on the
person for drawing up of representation about him. At
perception of the stranger we trust the primary
information on him more. At perception of the familiar
person the effect of novelty passes, that is newer
information is more significant.
www.themegallery.com
Attraction
• is a process of formation of appeal of any person
for perceiving, and a product of this process, that
is some quality of attitudes.
• Process of formation of attraction is influenced
with similarity of characteristics of the subject and
object of perception, "ecological" characteristics of
process of dialogue (affinity of partners on
dialogue, frequency of meetings, etc.), type of
interaction of partners on dialogue, character of
"reinforcement" and other factors.
•
www.themegallery.com
Effects of interconnections
• During dialogue there
can be a number of the
effects influencing on
specificity of interaction
of partners. It is possible
to attribute to such
effects: projective
identification, a transfer,
a countertransfer.
www.themegallery.com
Projective identification
• –introduction of feelings of the partner to other
partner on dialogue. If it occurs between the
doctor and the patient, the doctor can be
dangerous to both as at the doctor as a result
of it will be internal psychological misbalance,
and he will need psychological help.
www.themegallery.com
Transfer –
• the tendency in the present to see the past, to
resort to use of old ways of perception and
reaction, including any new information.
• In clinical practice in case of presence of
transfer the client begins interaction with the
doctor as with someone another (mother, the
father, etc.).
www.themegallery.com
Coutertransfer
• And the doctor can test any feelings in relation
to the patient, starting with his past. This
phenomenon refers to a countertransfer. The
countertransfer amplifies in experience of
stressful events and non-authorized conflicts
in a life of the doctor. The countertransfer can
be considered as reaction on internal
disbalance which is shown as anger to the
client, irritations, fear of the client and so forth.
www.themegallery.com
Communicative competence
• It is possible to speak about the importance for
effective and on-conflict interactions between the
patient and doctors such concept, as communicative
competence, i.e. abilities to establish and support
necessary contacts to other people. This process
means an achievement of mutual understanding
between partners on dialogue, best understanding of a
situation and a subject of dialogue. It is necessary to
note, that communicative competence is professionally
significant characteristic of the doctor and the nurse.
However, in spite of the fact in conditions of clinic the
patient is compelled to address for help to the doctor,
communicative competence is important and for the
patient.
www.themegallery.com
L/O/G/O