Camilla M. Anderson

In any given doctor-patient relationship one can be reasonably certain that some of the most potent factors in achieving whatever results are obtained remain elusive, particularly to the participants. Despite his preoccupation with dynamic factors it is often as difficult for the doctor to see himself accurately here as it is for an untrained person in a life situation. Sound movies would help, but these are not available to most of us. The inflection in the voice, a sigh, a silence, a frown, or muscle tensions of which the doctor is totally unaware are often details which are important, for they give the patient cues concerning the doctor's feelings, and these the patient is prone to interpret as having a relation to himself.

The doctor, especially the less-experienced one, having learned what some of the essential ingredients of this relationship are supposed to be, may be quite handicapped by this very knowledge, for he may have his mind and attention more fixed on himself and on what he is doing than on the patient. A medical student in a Psychiatric Out-Patient Clinic recently described how knowledge can be a handicap when he said, “I get so intent on trying to elicit the dyanmics of a case, lest I appear stupid to the instructor, that I forget I am dealing with a person.”

A most essential ingredient in this relationship is certainly the abiding awareness of the doctor that he is dealing with another human being, like himself, and not with a variety of specimen. We psychiatrists tend to be scornful when we hear our medical colleagues say, “This is the man with the heart,” or “This is the woman with the thyroid,” but there is little difference between such insights and some of our own chatter about patients in terms of their complexes, envies and fears.

There exists a belief among many of us that there is a hierarchy of skills in psychotherapy, with psychoanalysis at the apex. Often coupled with this is the assumption that to have self-respect and therefore the res