ABSTRACT
The success of psychotherapy may be jeopardized by an infinite variety of factors. These are usually introduced by the patient but may on occasion be the unconscious contribution of the psychotherapist. This chapter discusses the practice of addressing adult patients in psychotherapy by their first names. A number of speculative reasons for this phenomenon have been advanced. These include the need to feel superior to the patient, the need to minimize the patient’s illness, and the tendency to avoid therapeutic commitment. A number of therapists will use a patient’s first name as a friendly gesture that they hope will make it easier for the patient to relate to them. A psychotherapeutic relationship based on friendship may meet with initial success but can ultimately hinder the patient’s freedom to express himself. The patient appeals to the psychiatrist for help with emotional problems usually involving some degree of anxiety.
