ABSTRACT
Feelings are facts. Psychodynamic psychiatry helps understand the facts and how they influence the patients and the professional responses to them, and so contribute to the 'art' of medicine. Psychodynamic understanding is an art, but it is also a science and a moral discipline. It is an art in that ultimately impossible to legislate for the tact, timing, sensitivity and creativity that make up a helpful encounter between doctor and patient. It is a science in that psychology, psychoanalysis and child development inform the understanding of the dynamics of relationships. It is moral discipline in that in the encounter with the patient people are always struggling to do and say the 'right' thing in the face of human suffering. This struggle is as much with people's own inadequacies, negativity, anxiety and pessimism as with those of the patient, even if they sometimes comfort themselves with the thought that, via projective identification, these arise in 'the patient' rather than themselves.
