ABSTRACT
The Hippocratic Oath, which first defined the ethical relationship between the physician and the patient, demands that the physician ‘first do no harm.’ It is assumed that physicians only intend well to their patients and, in the reverse, that they intend no harm when they treat their patients. In 1910, Freud described, for the first time in the medical literature, the fact that he as a psychiatrist had feelings toward his patients and he noted that these feelings had to be taken into account when treating the patient. He introduced the analytic concept of countertransference. Prior to the psychopharmacology revolution, Winnicott (1949) described two cases in which he grew to hate his patients. Winnicott had difficulty with the first patient, who had a psychotic disorder, because he was unable to influence the illness process. The second patient he described had an antisocial personality disorder, which seemed to actively frustrate the treatment process.
