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On Becoming a Psychiatrist: Discussion of "Empathy and Intuition in Becoming a Psychiatrist" by Ronald J. Blank. Robert Langs. Pp. 255-279.
The experience of being a novice therapist intensely involved for the first time in trying to understand and help a patient is recounted in detail by Blank. Using Blank's narrative as an illustration, Langs considers various motivations for selecting psychiatry as a career and discusses how they can function as assets or liabilities to learning. Projective and introjective identifications with the patient stem from the therapist's efforts to seek specific gratifications and defensive postures. This can lead to the shutting off of particular material from the patient, fear of interpretation, or institution of unanalyzed modifications of the methods of treatment. "So-called empathic experiences" may function as rationalizations for these errors. It is necessary to include a mechanism for validation of hypotheses as part of therapeutic technique and to remember that patients' remarks may refer to real observations of the therapist as well as to transference fantasies. A brief response by Blank is appended to this article.