When the Practitioner Cannot Attune: A Barrier to Healing

When a healthcare practitioner struggles to attune to a patient, the relational dynamic becomes strained. The practitioner may fail to notice or respond to the patient’s emotional, physiological, and relational cues, leading to a sense of disconnection and misattunement. For the patient, this lack of connection can amplify feelings of vulnerability, fear, or mistrust. It may also hinder their ability to feel safe, understood, and supported, disrupting the conditions necessary for healing. The patient’s nervous system remains in a heightened state of stress or dysregulation, making it more challenging to engage in the therapeutic process.

For the practitioner, an inability to attune can lead to frustration, self-doubt, or burnout. The practitioner may misinterpret the patient’s responses as resistance or non-compliance, further compounding the disconnect. Over time, this can erode the practitioner’s confidence in their ability to help and diminish their own sense of well-being. Both parties become caught in a cycle of dysregulation, with the absence of co-regulation perpetuating the challenges. This mutual struggle impairs the therapeutic relationship and limits the potential for transformative outcomes.

When a healthcare practitioner struggles to attune to a patient, their typical responses often stem from their own dysregulation or discomfort. Common reactions may include:

Shutting Down or Withdrawing: The practitioner may emotionally distance themselves, avoiding deeper engagement with the patient. This can manifest as a rigid, overly clinical approach, focusing solely on tasks or protocols rather than the relational aspects of care.

Overcompensating with Control: In an attempt to regain a sense of competence, the practitioner may double down on authority, offering unsolicited advice, excessive explanations, or directives without considering the patient’s perspective or needs.

Pathologizing the Patient: The practitioner might attribute the disconnect to the patient’s behavior, labeling them as resistant, difficult, or uncooperative, rather than reflecting on their own capacity to attune.

Seeking to Fix Quickly: Driven by discomfort with relational tension, the practitioner may rush to solutions or interventions, prioritizing efficiency over understanding the deeper relational dynamics or emotional state of the patient.

Projecting or Deflecting: Practitioners may unconsciously project their own unresolved emotions onto the patient or deflect responsibility by blaming external factors, such as time constraints or institutional pressures.

These responses often exacerbate the disconnect, leaving both the patient and practitioner further dysregulated. Without reflection or support to address their own state, the practitioner remains unable to repair the relational rupture, reinforcing a cycle of ineffective care.

About Shay Seaborne, CPTSD

Former tall ship sailor turned trauma awareness activist-artist Shay Seaborne, CPTSD has studied the neurobiology of fear / trauma /PTSD since 2015. She writes, speaks, teaches, and makes art to convey her experiences as well as her understanding of the neurobiology of fear, trauma theory, and principles of trauma recovery. A native of Northern Virginia, Shay settled in Delaware to sail KALMAR NYCKEL, the state’s tall ship. She wishes everyone could recognize PTSD is not a mental health problem, but a neurophysiological condition rooted in dysregulation, our mainstream culture is neuro-negative, and we need to understand we can heal ourselves and each other through awareness, understanding, and safe connection.
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