Editor word: Issue 1 2025
- Hans-Peter Mofors
- 3 days ago
- 3 min read
Updated: 2 days ago
I communicate, therefore I am... From our first day to our last, we relate to others. This communication - just as vital as water and food - largely takes place without words. Exchange with others forms the foundation of our existence and creates space for all of life’s possibilities. Yet it is precisely in this exchange that we so often lose our way, which becomes the basis for many misunderstandings, often with significant consequences.
In the world of medicine, communication is brought to a head. The patient describes their suffering to the physician, who interprets and assesses the reported, observed, and examined information. The doctor communicates their evaluation along with suggested measures - hopefully with a reasonable dose of empathy. The patient responds to what they’ve understood, and the consequences of this continue to unfold elsewhere. The physician documents their understanding of what was communicated in the medical record.
In a perfect world, this process works seamlessly. Diagnosis and treatment align with the subjective suffering, hopefully resulting in actions that lead to cure or relief. But still, things often go wrong. “The doctor didn’t seem to listen, he didn’t understand what I was saying...” Behaviors are interpreted - based on reports and observations - as psychotic, depressive, aggressive, manic, autistic, and so on, leading to various interventions. Most of the time, hopefully, the interpretation is accurate. But far from always.
The meeting between caregiver and patient demands much of both parties. The likelihood of misunderstanding or miscommunication is high. How can suffering be described as accurately as possible? The right words are hard to find - thoughts and symptoms are too abstract or frightening. This elusive reality often leads to difficult-to-understand communication. As psychiatrists, we are expected - often within limited timeframes - to understand people’s inner worlds and to seek ways forward. Assessing the presence of thought disorders, psychotic or depressive symptoms is a significant challenge. Moreover, it’s a delicate task to communicate the assessment constructively and to invite dialogue about its reasonableness.
Many factors contribute to us losing our way in everyday clinical practice: differences in vocabulary, sometimes due to mutual language barriers. Cultural and social backgrounds influence the perceived message, as do contextual factors. To increase diagnostic accuracy, various assessment instruments are increasingly used. Unfortunately, blind trust in these tools often leads to undesirable outcomes, with both over- and under-diagnosis.
Communicative challenges also exist on a meta level. Knowledge in healthcare and science is processed and reinterpreted - sometimes beyond recognition. Entrenched beliefs are hard to shift. Some people are persuasive in their arguments, and almost anything can come across as truth. The media narrative influences - and sometimes distorts - a balanced picture of reality, a fact those of us in psychiatry are well acquainted with. Workplaces represent a chapter of their own, where communicative missteps - by both staff and leadership - can steer the organization in entirely unexpected directions.
In this issue of The Nordic Psychiatrist, the joint journal of the Nordic psychiatric associations, we have chosen to focus on the challenges of interpersonal communication. The areas are many, but so are the opportunities to bridge the difficulties. A basic condition for success is humility in the face of these challenges - resisting the assumption that the message has landed as intended simply because we believe it has. There is a wealth of knowledge on this topic among colleagues in our Nordic countries, which they generously share in this issue. □
With hopes for rewarding reading!
Hans-Peter Mofors Chief editor
