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Physicians are constantly appraising the coping styles of their patients, and these appraisals dictate both diagnosis and treatment.
Though there are multiple definitions of coping, coping with chronic illness is best defined as the behavioral style that patients use to bring quiescence and peace of mind to their medical predicament.
There are consistent characteristics of effective and less effective coping styles, and it is essential that psychiatrists who treat medically ill patients assess their patients' particular coping mechanisms in order to deliver optimal care.
Coping with illness can be a serious problem for both the patient and the physician. Indeed, the irony of our increasing prowess in healing is our growing discomfort and our profound sense of impotence when a cure cannot be found, and when coping is the order of the day. This dilemma is both consciously realized and unconsciously experienced; both patients and staff feel the ripple effect.
Fortunately, the psychiatrist is ideally suited to assist both the patient and the physician with the complexities of medical illness, and to pay careful attention to the complex feelings that chronic suffering engenders (in the inpatient consultative setting as well as in the outpatient clinic). In fact, there is a growing body of literature that focuses on the different mechanisms by which patients cope with chronic disease and the corresponding psychotherapeutic interventions for the patient with chronic illness. This chapter addresses the fundamentals of how patients cope, as well as the art of working psychotherapeutically with the medically ill.
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