ABSTRACT
A close relationship is often perceived as a 'good' doctor–patient relationship, though this may just reflect the doctor's feeling that he 'likes' the patient. The antecedents to the defensive behaviour were often easier to understand than the nature of the behaviour itself, though that is probably to do with the fact that an explanatory sentence is often easier to compose than a succinct definition. This chapter reviews some of the defences deployed by primary care doctors. It is important to stress that empathic engagement, far from being a snare to be avoided, is an essential step while working with patients. A patient, the young woman with breast cancer, elicited a protective response from the doctor. The doctor's presentation was vivid and charged with obvious emotion. A number of the cases presented in the group appeared to be clear examples of counter-transference being at work, although it seems likely that it underpins all the defensive postures.
