The commodification of relationships hurts them. In Surviving America’s Depression Epidemic: How to Find Morale, Energy, and Community in a World Gone Crazy Bruce Levine discusses how the patient-psychiatrist relationship has been undermined by consumerism. On one hand, managed health care demands snappy diagnoses and generic prescriptions – not exactly a fertile scenario for deep friendships. On the other hand, exchanging money for a deep friendship feels icky (for lack of a better word).
The psychiatrist-patient relationship is particularly interesting because it is one which is nominally concerned with the healing of emotional wounds. This is something for which friendships and deep relationships are also really important. The dangers of over-commercializing or commoditizing a doctor-patient relationship are present for other kinds of relationships, too. I would suggest that virtually all relationships in the American Paradigm are seen in the context of the exchange of goods and services. Case in point: I regret something I once said to a significant other. I said that doing nice things for one another is what loving relationships are “all about.”
Doing nice things for one another is nice. Moreover, I like doing things for people who are important to me, and (of course) I like having nice things done for me. Even at the time, I didn’t think of it as a profound statement. It was just something offhand. But my point is that gifts are not what loving relationships are “all about.” In saying so, I had stumbled into a subtle and pervasive lie of our culture. The exchange of gifts (material or otherwise) is a natural consequence of a strong relationship, not the foundation.
The book explores good territory, and it’s an engaging read. It’s particularly relevant for those who want to think carefully about the kinds of professional relationships they want to build with their patients. But I think it has wider relevance, too.