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This article has been peer reviewed. It is the author's final manuscript version prior to publication in the Journal of General Internal Medicine 17(11):874-81, November 2002. The published version is available at


The emotional investment required to construct a caring doctor-patient relationship can be justified on humane grounds. Can it also be justified as a direct physiologic intervention? Two lines of evidence point in this direction. People in an empathic relationship exhibit a correlation of indicators of autonomic activity. This occurs between speakers and responsive listeners, members of a coherent group, and bonded pairs of higher social animals. Furthermore, the experience of feeling cared about in a relationship reduces the secretion of stress hormones and shifts the neuroendocrine system toward homeostasis. Because the social engagement of emotions is simultaneously the social engagement of the physiologic substrate of those emotions, the process has been labeled sociophysiology. This process can influence the health of both parties in the doctor-patient relationship, and may be relevant to third parties.