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A central task of psychiatrists working with the medically ill is to understand patients’ subjective experiences of illness to design therapeutic interventions that modulate the patients’ behavioral or emotional responses, decrease their distress, and improve their medical outcomes. Physicians witness a tremendous diversity of emotional and behavioral responses to illness. Some individuals face devastating illnesses for which no cure is currently available with courage and a sense of humor (Druss and Douglas 1988). Others, facing easily treatable illnesses, have difficulty overcoming intense emotions such as anger, fear, or hopelessness. Clinical experience and research indicate that illness variables such as severity, chronicity, or organ system involvement cannot predict an individual’s response to any given medical illness (Lloyd 1977; Sensky 1997). It is in the realm of the individual’s subjective experience of an illness that one can begin to understand his or her emotional and behavioral responses (Lipowski 1970).
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