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June 27, 1986

Attachment Behavior in Hospitalized Patients

JAMA. 1986;255(24):3391-3393. doi:10.1001/jama.1986.03370240061037

ILLNESS and hospitalization are major stresses that mobilize intense fears: fears of death, injury, loss of control, stranger anxiety, and separation anxiety. Despite these stresses, most people will enter the hospital and assume the patient role. One important way people adapt to the patient role is by finding a physician who explains their symptoms in a way they can understand. The physician occupies a social position of respect, reverence, and influence comparable with the parental role.1

Many theoretical models (paternalism, legal, economic, religious, physician conscience)2-4 have been proposed to explain the relationship between the physician and the patient. The concept of transference, the unconscious assignment to others of feelings and attitudes that were originally associated with important figures in one's early life, is usually invoked as a major underpinning of the physician-patient relationship. Another model, which complements and extends other notions about interactions between physicians and their patients,