March, 2024. There are many ways in which we, as treating clinicians, need to be attuned to our patients’ needs and concerns. I’m using the word “attunement” here as a goal that should be fundamental in our work. We should strive to be attuned to our patients—even, perhaps especially, those with whom we have little in common. In our professional lingo, “empathy” comes close—seeing ourselves from the outside and our patients from the inside. This may seem self-evident, but even so, we need to remind ourselves to ask the right questions and then to listen carefully to the answers. We cannot understand what ails our patients if we don’t understand who they are and what their priorities are.

There are an infinite number of barriers that can get in the way. Time pressure, paperwork, computer algorithms, it’s a long list, and never mind trying to stay focused when personal crises sometimes seem to be spinning out of control. But that’s life in the medical big city, where there can be bumps and potholes and running out of gas. This is old news, you say. Right. What’s remarkable, however, is how well most of us manage most of the time—but maybe not always. When that’s the case, let’s not forget to take a breath, ask our patient “What was that you just said?” and listen carefully this time.

In this issue of the Journal, there are a number of reports that call our attention to special challenges to our goal of attunement. Carter Do and colleagues, for example, shine a light on the needs of Vietnamese Americans, citing the many differences between their culture and our Western ways. For American clinicians, “tuning in” to their world, as much as possible, is essential, and this report is a primer to guide us along those lines.

Also in this issue, Gasnier and colleagues provide a review of the special needs of refugees with posttraumatic stress disorder who present with psychotic and somatic symptoms. Here again, the suffering of these patients occurs in the context of their world, where the meaning of aches and pains may differ from what we’re used to.

And finally, in the journal’s Practitioner’s Corner section, Peteet presents an intriguing essay entitled “The Moral Dimension of Mental Health Treatment.” He proposes that “attending to the moral life is fundamental” to shaping the direction of treatment, achieving clinical aims, and approaching the moral challenges faced by clinicians. One reference is to the “nonjudgmental” nature of the therapeutic stance as the clinician strives to understand the patient’s disturbed behavior and the person behind the symptoms, yet not requiring neutrality on the therapist’s part regarding the consequences of the patient’s behavior. The reflections in this report illustrate the complexity of attunement. How do we suspend our own moral values as we strive to tune into the patient’s worldview, where what’s perceived as moral or immoral may be very different from our own.