ABSTRACT
In Mental Handicap and the Human Condition, Sinason offers an interpretation of Shakespeare's portrayal of Richard III's deformity. Sinason suggests that while this may have satisfied Richard's need to make sense of his affliction, it may also have created what Sinason termed a "secondary handicap" as Richard became consumed by anger and misery and a sense that he was unlovable. This chapter presents a model of supervision for health professionals (particularly nurses) that may help to avoid, or at least minimise, secondary handicap in institutions. This model is based on the idea that through encouraging reflection in caregivers, and in raising awareness of their own needs and reactions, individuals and teams in institutions will be enabled to achieve a balance between encouraging their patients' freedom of choice and its consequences.
