Abstract
Role differences in healthcare systems are the very foundation of communication in this specific field of environment. It has to be understood as a collective corporation between collective individuals and thus connect through intertwined border zones. These border zones between collective communicators holds the notions of individuality, which is represented in the ability to decipher and negotiate the multiple layers in the communicative border zone. These processes in border zones of persons - in relation with others - are dealt with by the Semiotic Skin Theory. In addition, the biological skin is central for human lives and the Semiotic Skin is conceptualized as a socio-somatic-semiotic, layered and dynamic membrane that operates as a semi-permeable, communicative boundary. A constant interpretation between a self-reflecting system and an unending spiral of semiosis is the emergent of the semiotic skin. It creates a semi-permeable barrier that holds the very notions of the multi-layered skin-on-the-skin that is reflected in an embodied communication between humans and environment. In this theoretical understanding of an embodied aspect of not only meaning-making but also the regulative aspect of embodied interaction with others, the very idea of borders of individuality becomes the notion of interpretation. Any communication in a medical setting involves actions on the border of mutual understanding - e.g. communication between a pediatrician and a child. The concepts of a collective patient and a collective doctor are introduced as to understand the aspects of the multiple dynamics of the semiotic skin as the holder of an individual’s personal ideas/interpretations in the interaction with one other person, holding multiple aspects from others as well. Examples of the interaction between patients and the healthcare system in Denmark illustrate how a new theoretical and practical performance of mastering the communicative partnership in the cross field between the healthcare system and psychology is born.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
An invisible patient and invisible doctor are defined by parts of the collective patient/− doctor that is not always represented. E.g. when a teenage child attends the doctor with the parents because of fatigue and stomach ache and the child is afraid of having cancer because a cousin had the same symptoms and died of cancer last year. This “voice” of the cousin is invisible until it is being explicitly described.
References
Als, H., Tronnick, E., & Brazelton, T. B. (1980). Affective reciprocity and the development of autonomy. Journal of the American Academy of Child Psychiatry, 19, 22–40.
Anikonov, D. S., & Konovalova, D. S. (2011). The integral geometry boundary determination. Problem for a pencil of straight lines. Siberian Mathematical Journal, 52(5), 763–775.
Beebe, B., Alson, D., Jaffe, J., Feldstein, S., & Crown, S. (1988). Vocal congruence in mother-infant play. Journal of Psycholinguistic Research, 17, 245–259.
Brinkmann, S. (2009). Psyken. Mellem synapser of samfund. Aarhus: Aarhus Universitetsforlag.
Hai, H. (2013). The ontological status of meridians. In H. Hai (Ed.), Acupuncture. Theories and evidence (pp. 47–52). London: World Scientific.
Hermans, H. J. M. (2001). The dialogical self: Toward a theory of personal and cultural positioning. Culture & Psychology, 7(3), 243–281.
Hermans, H. J. M. (2015). Dialogical self in a complex world: The need for bridging theories. European Journal of Psychology, 11(1), 1–4.
Hoffmeyer, J. (2008). Biosemiotics. An examination into the signs of life and the life of signs. Chicago: University of Scranton Press.
Innis, R. E. (2016). Between philosophy and cultural psychology: Pragmatist and semiotic reflections on the thresholds of sense. Culture & Psychology, 22(3), 331–361.
Kaye, K., & Fogel, A. (1980). The temporal structure of face-to-face communication between mothers and infants. Developmental Psychology, 16, 454–464.
Lundeberg, T. (2013). Mechanisms of acupuncture in pain: A physiological perspective in a clinical context. In H. Hai (Ed.), Acupuncture. Theories and Evidence. London: World Scientific.
Marsico, G. (2011). The “non-cuttable” space in between: Context, boundaries and their natural fluidity. Integrative Psychological and Behavioral Science, 45, 185–193.
Marsico, G. (2018). The challenges of the schooling from cultural psychology of education. Integrative Psychological and Behavioral Science, 52(3), 474–489.
Marsico, G., Cabell, K., Valsiner, J., & Kharlamov, N. (2013). Interobjectivity as a border: The fluid dynamics of “betweenness”. In G. Sammut, P. Daanen, & F. Moghaddam (Eds.), Understanding the self and others: Explorations in intersubjectivity and interobjectivity (pp. 51–65). London: Routledge.
Mata, I., Molins, E., & Espinosa, E. (2007). Zero-flux surfaces of the electrostatic potential: The border of influence zones of Nucleophilic and electrophilic sites in crystalline environment. American Journal of Physical Chemistry, 111(39), 9859–9870.
Merritt, M. M. (2009). Kant’s argument for the apperception principle. European Journal of Philosophy, 19(1), 59–84.
Nedergaard, J. I. (2016). Theory of semiotic skin: Making sense of the flux on the border. Culture & Psychology, 22(3), 387–403.
Nedergaard, J. I. & Jensen, E. S. (2018). Communicative partnership between more than two: When a child becomes a patient. In Freda, M. F., Salvatore S., De Luca Picione R., Nedergaard, J. I. (Edts). Health and Idiographic Process. Charlotte: Information Age Publishing (In Press).
Nedergaard, J. I., Valsiner, J., & Marsico, G. (2015). “I Am not THAT KIND OF…”: Personal Relating With Social Borders. In B. Wagoner, N. Chaudhary, & P. Hviid (Eds.), Integrating Experiences. Body and Mind Moving Between Contexts. Charlotte: Information Age Publishing INC.
Neuman, Y. (2003). Processes and boundaries of the mind. Extending the limit line. New York: Kluwer Academic/Plenum Publishers.
O’Byrne, D. J. (2001). On passports and border controls. Annals of Tourism Research, 28(2), 399–416.
Oeckl, R. (2003). A “general boundary” formulation for quantum mechanics and quantum gravity. Physics Letters B, 575(3–4), 318–324.
Papousek, M., Papousek, H., & Symmes, D. (1991). The meanings of melodies in motherese in tone and stress languages. Infant Behaviour and Development, 14, 415–440.
Popescu, G. (2010). Borders and boundaries. In B. Warf (Ed.), Encyclopedia of geography (p. 293f). Thousand Oaks: SAGE publications, Inc.
Popescu, G. (2012). Bordering and ordering the twenty-first century. Understanding Borders. Lanham, Maryland: Rowman & Littlefield Publishing Group, Inc..
Rayner, A. D. (2011). Space cannot be cut – Why self-identity naturally includes neighborhood. Integrative Psychological & Behavioral Science, 45, 161–184.
Rhoades, R. A., & Bell, D. R. (Eds.). (2009). Medical physiology. Principles for clinical medicine (3rd ed.). Baltimore: Lippincott Williams & Wilkins.
Rommetveit, R. (1983). In search of a truly interdisciplinary semantics: A sermon of hopes of salvation from hereditary sins. Journal of Semantics, 2, 1–28.
Tapp, K. (2012). Symmetry, a mathematical exploration. New York: Springer.
Valsiner, J. (2014). An invitation to cultural psychology. London: Sage.
Varzi, A. (1998). Basic problems of Mereotopology. In N. Guarino (Ed.), Formal ontology in information systems. Amsterdam: IOS Press.
Von Uexküll, J., & von Uexküll, T. (2004). The eternal question: Biological variations on a platonic dialogue. Sign Systems Studies, 32(1/2), 329–362.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nedergaard, J.I. Role Differences in Healthcare: Overcoming Borders through Semiotic Skin is the Basis for Communication. Integr. psych. behav. 53, 283–297 (2019). https://doi.org/10.1007/s12124-018-9458-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12124-018-9458-2