ABSTRACT

This chapter considers a number of issues such as: the doctors' perception of how much time and energy are available at any given juncture; how important it is for doctors that patients should respond positively to their ministrations; and how personal experiences in the doctor's life can determine professional actions. Diagnostic confusion, may be a signal that the patient has, consciously or unconsciously, rendered the doctor's professional skills ineffective by exercising control in a way which is not immediately apparent. The patient talks and the doctor listens, but the process seems unproductive. The patient might be obtaining benefit from the consultations which the doctor felt were so dysfunctional. The group discussion sought to understand what had changed between doctor and patient. In some cases the influence of the personal self is obscure, difficult to detect. The examples in the chapter talks about defences seem to be there simply to protect the professional self from external threats.