Psychiatrists' Illustration of Awe in Empathic Listening Assessments: A Pilot Study

Parameshwaran Ramakrishnan; Thomas M Brod; Thomas Lowder; Prasad R Padala

doi:10.7759/cureus.55684

Psychiatrists' Illustration of Awe in Empathic Listening Assessments: A Pilot Study

Cureus. 2024 Mar 6;16(3):e55684. doi: 10.7759/cureus.55684. eCollection 2024 Mar.

Authors

Parameshwaran Ramakrishnan^{1

2}, Thomas M Brod³, Thomas Lowder⁴, Prasad R Padala¹

Affiliations

¹ Psychiatry, Baptist Health-University of Arkansas for Medical Sciences, Little Rock, USA.
² Department of Theology, Ethics, and Natural Sciences, Graduate Theological Union-University of California at Berkeley, Berkeley, USA.
³ Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
⁴ Graduate Medical Education, Baptist Health-University of Arkansas for Medical Sciences, Little Rock, USA.

Abstract

Background "Awe" is typically an inspiring emotional response to perceptually vast stimuli signifying the transcendence beyond all cognitive frames of reference when we encounter the unexpected. Physicians' experience of awe in clinical care interactions has not been studied in an empirical, evidence-based way. We aim to present a focused study of awe in a psychiatrist's empathic listening (EL) assessments and propose an evidence-based framework to study it. Methodology This is an exploratory case series of a psychiatrist's EL interactions (mean duration/x̄ of 46.17 minutes) with six patients (two males and four females) aged 32-72 years (x̄ =54.67, σ = 16.64). Using the method of autoethnography, the verbal and nonverbal aspects of the EL assessments were analyzed and open-coded to generate qualitative data. Results The study revealed that the data in all the case studies could be classed into two thematic groups, namely, mindfulness and transpersonal mindfulness. The emotions of "awe" and "non-agency" were ubiquitous in all six case studies both for the psychiatrist and patients. Conclusions Recognizing the awe and non-agency in EL interaction is essential in conceptualizing the "mindfulness-to-transcendence" framework and the first step toward the evidence-based study of transcendence/metaphysics in phenomenological psychiatry.

Keywords: analytical autoethnography; awe and non-agency; clinical chaplaincy; contemplative neuroscience; empathic listening; evidence-based medicine (ebm); metaphysics and phenomenology; non-dual and non-agency; transcendent unknowable; transpersonal mindfulness.