Special Series: Psychological Elements of Palliative Care

Palliative care has been shown to help patients live well with serious illness, but the specific psychological factors that contribute to this benefit remain investigational. The therapeutic relationship has been proposed as a key element in beneficial patient outcomes, possibly because it supports patient and family coping. In 2019, an exploratory seminar called “Healing Beyond the Cure: Exploring the Psychodynamic Aspects of Palliative Care” was held at Harvard University’s Radcliffe Institute for Advanced Study. This interdisciplinary seminar began a conversation about the psychological elements of the palliative care encounter which inspired this series. This series on the psychological elements of palliative care defines elements of this therapeutic relationship in palliative care. Palliative care is not psychotherapy. Yet, it can adapt terms and concepts from traditional talk therapy to help clinicians better understand what’s going on when they interact with patients. These concepts include frame and formulation, transference and countertransference, clinical attunement, attachment, and the holding environment. The idea behind the series is that a deeper understanding of these elements can improve the delivery of palliative care. Additional papers in this series look at how these concepts help describe the benefits of palliative care for referring clinicians, how these concepts can bolster clinician wellness and resiliency, and how these concepts apply during end-of-life transitions like enrollment in hospice.