Treatment: The “Social” Ingredients

Treatment: The “Social” Ingredients Often what ails us can be treated through medical intervention. The treatments vary widely—from a simple change in diet to vitamin and mineral supplements, aspirin, antibiotics, surgery, and the like. Medicine is vital to health. In addition, however, treatment has a social component, what the family doctor used to call “bedside manner.” What are the active social ingredients?

First, all healers—regardless of whether they are medical doctors, psycholo- gists, or others—provide social support, a close human relationship characterized by warmth, expressions of concern, a shoulder to cry on, and someone to talk to. Earlier, we discussed the benefits to health and longevity of having social contacts. In psychological therapy, studies have shown that the better the “working alli- ance” is between a therapist and client, the more favorable the outcome is likely to be. As psychotherapist Hans Strupp (1996) put it, “The simple and incontrovertible truth is that if you are anxious or depressed, or if you are experiencing difficulties with significant people in your life, chances are that you feel better if you talk to someone you can trust”.

Second, all therapies offer a ray of hope to people who are sick, demoralized, unhappy, or in pain. In all aspects of life, people are motivated by upbeat, posi- tive expectations. Although some of us are more optimistic than others, optimism is a specific expectation that can be increased or decreased in certain situations. Indeed, all treatments communicate positive expecta- tions. It has been suggested that this optimism alone can spark change even when it is not justified. This suggestion is consistent with the well-known placebo effect in medicine, whereby patients improve after being given an inactive drug or treatment. Believing can help make it so, which is how faith healers, shamans, and witch doctors all over the world have managed to perform “miracle cures” with elaborate rituals. Even modern medicine exploits the power of hope. As Walter Brown (1998) puts it, “The symbols and rituals of healing—the doctor’s office, the stethoscope, the physical examination—offer reassurance”.

A third important ingredient is choice. Allowing patients to make meaningful choices, such as deciding on a type of treatment, increases the effectiveness of treatments for alcoholism and obesity (Mendonca & Brehm, 1983). Choosing to undergo an effortful or costly treatment is particularly beneficial in this regard. The person who voluntarily pays in time, money, or discomfort needs to self-justify that investment—a predicament sure to arouse cognitive dissonance.

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