The patient's brain : the neuroscience behind the doctor-patient relationship / Fabrizio Benedetti.

Includes bibliographical references and index.

Print version record.

Due to advances within neuroscience, we are now in a better position to be able to describe and discuss the biological mechanisms that underlie the doctor-patient relationship. Using this knowlege, this book describes and demonstrates the power that the doctor's behaviour has on a patient's behaviour and capacity for recovery from illness.

Preface; Acknowledgements; 1 A brief evolutionary account of medical care; SUMMARY AND RELEVANCE TO THE CLINICIAN; 1.1 Simple organisms can take care of themselves; 1.1.1 Unicellular organisms use simple strategies to protect themselves; 1.1.2 The withdrawal reflex is present in both invertebrates and vertebrates; 1.2 From the scratch reflex to grooming; 1.2.1 The scratch reflex is a simple purposive behaviour; 1.2.2 Grooming involves a complex behavioural repertoire; 1.3 Scratching somebody else: a big evolutionary jump to social behaviour

1.3.1 Primates spend plenty of time in social grooming1.3.2 From social grooming to altruistic behaviour; 1.4 Taking care of the sick; 1.4.1 From early forms of altruism to the emergence of the shaman; 1.4.2 More rational treatments emerge slowly from prehistoric to historic medicine; 2 Emergence and development of scientific medicine; SUMMARY AND RELEVANCE TO THE CLINICIAN; 2.1 Emerging knowledge and the problem of animal experimentation; 2.1.1 Scientific medicine requires basic anatomical and physiological knowledge; 2.1.2 Acquiring new medical and surgical skills

2.1.3 Effective treatments need not be understood, but they do need validation2.1.4 Animal research impacts negatively on most people and raises many ethical concerns; 2.2 Biological, psychological, and social factors all contribute to illness and healing; 2.2.1 Modern scientific medicine includes a psychosocial component; 2.2.2 Medical concepts vary across cultures but the psychosocial component stays the same; 2.3 Medical practice meets neuroscience; 2.3.1 Scientific medicine needs to include the study of the patient's and doctor's brain

2.3.2 To become and to be a patient involves four steps and relative brain processes3 Feeling sick: a combination of bottom-up and top-down events; SUMMARY AND RELEVANCE TO THE CLINICIAN; 3.1 The patient feels sick through bottom-up and top-down processes; 3.1.1 What is a symptom?; 3.1.2 Detection of a symptom is a combination of interoception and other factors; 3.1.3 Different brain regions respond to interoceptive stimuli; 3.1.4 The insula plays a crucial role in awareness; 3.1.5 Interoceptive awareness undergoes a top-down modulation

3.2. Bottom-up and top-down processes contribute to the global experience of pain3.2.1 Pain experience is built up from the periphery to the central nervous system; 3.2.2 There is not a single pain centre but a distributed system; 3.2.3 Pain experience changes across individuals and circumstances; 3.2.4 A complex neural network is responsible for the top-down modulation of pain; 3.3 Emotions influence the perception of symptoms; 3.3.1 Feeling sick does not necessarily mean physical suffering; 3.3.2 Positive and negative emotions are processed in the limbic system

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