Dynamic Psychotherapy and the Disabled Psychiatrist

I am uneasy to think I approve of one object, and disapprove of another, call one thing beautiful, and another deform'd; decide concerning truth and falsehood, reason and folly, without knowing upon what principles I proceed.

This article addresses a number of issues related to being both a physically disabled psychiatrist and a resident learning dynamic psychotherapy. Issues such as transference, countertransference, professionalism, and resident supervision are addressed. Manifest disability is a provocative stimulus for protection both for patients and one's own colleagues. I review the literature of the psychiatrist as a real person as well as examine the impact of a disability on the psychiatrist. I then discuss my own experiences as a disabled psychiatric resident learning about psychiatry and the vicissitudes of this experience in terms of transference and countertransference. The effect of physical disability in the psychiatrist on therapeutic alliance has never fully been explored.

Psychiatrists, like all human beings, are vulnerable to illness and disability. Psychiatrists with various degrees of impairment of sensory or motor functions often diverge from the norms of appearance because of facial or bodily deformity. I will use some definitions from the Princeton Rehabilitation Institute cited by Corbett and Madorsky (1991) to distinguish certain descriptors. An impairment is some particular trait that a person is missing; it can be physical, mental, or emotional. A disability indicates that there is something a person cannot do because of that missing trait. A handicap, on the other hand, has to do with function. Some disabilities are not handicaps, depending on the physician's roles.