The idea that I have of psychoanalytic work applies to psychiatry too in that effective clinical work involves the practitioner engaging in looking at what their patient reminds them of in themselves but which is not identical to the patient’s experience.

The empathic resonance with the patient may allow the professional to recognise more closely something of the patient’s predicament through what it evokes in them. This is an unconscious emotional echo of the patient in the professional. This implies a mutual process of engaging in unconscious and conscious work, working through in the transference and counter-transference to become more aware of the meaning underlying a shared conflict.

In becoming conscious of what is their part in the problem and what is not, the professional might begin to think with their patient about their contribution to the conflict, and to help the patient to recover in the sense of recovering parts of their mind. At this level of sharing and working out conflict, an ordinary human encounter emerges which to my mind is at the heart of both psychiatry and psychotherapy.   

Sections

		The psychic warrior The patient is wearing a large overcoat as if something may well be hidden concretely underneath or within
		No tank you The the therapist is saying: ‘I sense you’re angry’.
		Keeping mum Clearly the therapist doesn’t know that Mr Jones has disappeared.
		Ivory tower Psychotherapists live in something of an Ivory Tower, removed from the acute disturbed situations
		Return and regression There is relief for the therapist that the patient is alive but a regret at the emotional work that still needs to be undertaken.
		Keeping abreast The process of striving to understand a patient’s problems using one’s intellect and reading.
		The psychic worrier The transformation - the psychotherapist remembers his dream.
		Self-reflection Psychotherapeutic work and psychiatric work often lay down an emotional gauntlet of a personal and professional challenge to the practitioner.
		Psychiatrist heal thyself The therapist faces himself and says he senses that he too is hiding something
		Being reminded The therapist is again inviting Mr Jones to reveal something of his own self.