Personas in the Practice of Medicine

Skimming through posts by other writers on Substack, I came across a short piece that started a chain reaction in my brain. Its title was Who did I meet in my clinic?

The author described the diseases in his patient encounters as personas who had more or less invaded the lives of the people afflicted by them. Suddenly that made a lot of sense to me, and I saw all the parallels to how we use the concept and the word personas or sometimes personalities for not just our patients, but medications and diseases and also, from a psychological perspective, archetypal individuals who shaped the life of our patients and, really, all of us.

I had never myself quite claimed the insight that diseases have personalities, but they do. Some diseases are always slow, some always fast and dramatic, some wax and wane and can sneak back up on you even when you think you are cured. Some follow a course of tightly scripted stages. Seasoned clinicians are intuitive masters of pattern recognition, which really means recognizing the personalities of diseases.

I often speak and write about how medications have personalities. Prozac can be energizing, Paxil can insulate you from emotional pain, Wellbutrin can make you less angry, Remeron can make you hungry, steroids can de-stabilize your mood and so on.

In all types of sales and marketing, the term persona can be used for training purposes in describing customers with varying degrees of interest or ability to buy a product. Are they just looking, do they want lots of information or will they make an emotional decision?

As a doctor meeting a new patient, I need to read them and try to figure out what they are looking for and I need to behave in a way that I believe is effective in building rapport and trust and a therapeutic relationship. I try to assess the patient’s personality or persona, and I show more of certain aspects of my own personality as the situation might require. Some people think this is dishonest, I feel very strongly that it is necessary if you want to reach people and help them heal.

Another important application of the concept of personas is those individuals who shaped our lives, archetypes in Jungian terminology. Being raised by a narcissistic mother is just one example of common personality types ability to influence others.

All this reminded me of the title of an Ingmar Bergman film, Persona, which I never watched as a young man in Sweden. The trailer on YouTube was not appetizing, so I don’t know that I will take the plunge and watch the movie, but it is supposed to have lot of Jungian stuff in it.

The bottom line here is that everything has personalities, breeds of dogs, brands of cars, types of wood, digital recordings, vinyl, albums, printed books and e-books.

It’s just a useful analogy in most walks of life.