Some of the people who present to
psychiatrists are very stuck in their lives, often drawing away
from life, and some are drawn towards death. These are the people
whose despair can permeate the professional encounter, sometimes
leading to an impasse in care.
Trying to find ways of thinking about the predicament of such
people is the psychiatrist's task and psychoanalytic thinking can
be of help in offering an understanding of the dynamics of this
drawing from life and the emotional impact it has on the
practitioner and their professional behaviour.
I work alongside consultant psychiatrists as a medically trained
psychoanalytic psychotherapist, consulting on the work they
undertake with patients who evoke difficult feelings in
professionals which make it hard to manage them effectively. A
central management problem with someone who evokes difficult
feelings is that it becomes hard to listen to them.
One of my other roles is to teach and train junior psychiatrists
about psychotherpy and to supervise them seeing patients for
therapy. Psychoanalytic ideas about people are difficult to grasp
in their abstract, theoretical form, and it is not until a doctor
begins seeing a patient for therapy that some of these ideas begin
to make sense. Developing a capacity to listen, to stay with, and
try to understand the patient's pain, is an achievement for many
doctors beginning therapy as the value of simply being listened to
is often greatly underestimated.
I have used the drawings which follow as a teaching tool about
relationships which use humour and humanity as a 'Trojan horse' to
help import some of these psychoanalytic ideas by making them more
accessible without undermining their complexity or underestimating
the emotional difficulties involved in trying to engage
meaningfully with this work.
Dr. James Johnston
Consultant psychiatrist in psychotherapy, Leeds
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Page last updated on 8 February
2009