Gabbard G O
JAMA. 1985;254(20):2926-9.
This article presents some observations from a workshop setting about the role of compulsiveness in the normal physician. Case examples illustrate the effect of this character trait on the professional, personal, and family life of the typical physician. Doubt, guilt feelings, and an exaggerated sense of responsibility form a compulsive triad in the personality of the physician. This triad manifests itself in both adaptive and maladaptive ways. This article focuses primarily on the maladaptive, including difficulty in relaxing, reluctance to take vacations from work, problems in allocating time to family, an inappropriate and excessive sense of responsibility for things beyond one's control, chronic feelings of "not doing enough," difficulty setting limits, hypertrophied guilt feelings that interfere with the healthy pursuit of pleasure, and the confusion of selfishness with healthy self-interest.
本文呈现了在研讨会环境下对强迫性在普通医生身上所起作用的一些观察结果。案例展示了这种性格特质对典型医生的职业、个人及家庭生活的影响。怀疑、内疚感以及过度的责任感在医生的人格中构成了一个强迫性三联征。这个三联征以适应性和适应不良的方式表现出来。本文主要聚焦于适应不良的方面，包括难以放松、不愿休假、在分配时间给家庭方面存在问题、对自身无法控制的事情有不恰当且过度的责任感、长期存在“做得不够”的感觉、难以设定界限、过度的内疚感干扰了对愉悦的健康追求，以及将自私与健康的自我利益相混淆。
