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