Physicians’ “compliance with treatment” in the context of consultation-liaison psychiatry: The role of “triangle” relationships and projective identification

Case report

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Authors: Thomas N Hyphantis, Konstantinos I Arvanitakis

Published Date August 2008 Volume 2008:2 Pages 189 - 193

DOI: http://dx.doi.org/10.2147/PPA.S3877

Thomas N Hyphantis¹, Konstantinos I Arvanitakis²

¹Consultation-Liaison Psychiatric Unit, Department of Psychiatry,Medical School, University of Ioannina, Ioannina, Greece; ²Department of Philosophy and Department of Psychiatry, McGill University Health Centre, Montreal, Canada

Abstract: Transference and countertransference issues arising in the context of consultation-liaison (C-L) psychiatry could be more complex than originally assumed since they include reactions evoked within the frame of a unique “therapeutic triangle” of the patient, the physician, and the C-L psychiatrist. A clinical vignette illustrates how the projective identification process could mediate the relationships between the members of the therapeutic triangle through the different transferences and countertranferences interwoven in the setting of C-L psychiatry. This, if left unchecked, may result in the disruption of professional relationships and in jeopardizing the treatment of patients.

Keywords: consultation-liaison psychiatry, compliance, transference, countertransference, projective identification

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