It was good to get back to my psychiatric placement at an NHS Mental Health Trust today and to a ward review meeting. I have been sitting in on clinic sessions at a university hospital with consultant psychiatrists covering new assessments, outpatient follow up appointments as well as team meetings discussing the management of care. It was two weeks since I was last at this ward review and it was heartening to notice the visible improvement in some patients in the intervening period.
There were a couple of patients who had regressed and this was producing some feelings in me (what is called counter transference). One patient, a middle aged man suffering with severe depression, was continuing to present with anxiety and helplessness. I felt like wanting to hug him. However, his depression is so severe that he has been prescribed a course of ECT. It is intriguing how some patients can invoke certain feelings and not others. Perhaps counter transference is when our own stuff and issues have been triggered and when we identify with the personal circumstances. I was particularly taken by the love and support of his partner (who was present in the session) and who appeared to be a rock of support in spite of very challenging circumstances. The experience made me aware of the vital role that carer groups undertake in the management of support networks for families and friends of those suffering from mental illness.
The 1-1 relationship between psychiatrist and patient
The importance of challenge in the therapeutic relationship
Transference and counter transference
Resistance in therapy
Dr Marie Keenan interview