chapter  4
20 Pages

Difcult Patients as First Cases

Because I do a great deal of supervision, I often sit across from young clinicians coping with feelings about their ‰rst outpatients. Before the initial sessions they are often anxious and excited, worried about “blowing it,” but hopeful. Usually they are aware that this patient means too much to them. There is too much pressure on the clinician and, in an indirect sense, on the patient. When things go wrong it is easy for me to have something similar to a parent’s long-term perspective (don’t worry, sweetheart, you will have other patients), but for the beginner it feels de‰ning.