Meissner W W, Wohlauer P
Int J Psychoanal Psychother. 1978;7:437-67.
Treatment problems arise both when the physician or other health care professional must be hospitalized for psychiatric disturbance and, even prior to hospitalization, in the process by which the physician comes to recognize and accept in himself an emotional illness of severe proportions. Hospitalization can represent a severe narcissistic trauma, which entails a radical role reversal (from caretaker to patient) and severely undermines the physician-patient's sense of personal and professional identity. Conflicts around these issues tend to become externalized within the hospital setting up characteristic patterns of conflict within the therapy (between patient and therapist) and within the ward community (between patient and ward staff, as well as between treating physician and ward staff). The expression of these conflicts and patterns of interaction are discussed in two cases-both psychotic and suicidal physicians-who, though the patterns of resistance and externalization took divergent forms, nonetheless expressed the same underlying issues.
当医生或其他医护专业人员因精神障碍而必须住院治疗时，以及甚至在住院之前，在医生开始认识并接受自身患有严重程度的情感疾病的过程中，都会出现治疗问题。住院可能代表着一种严重的自恋创伤，这需要彻底的角色逆转（从照顾者变为患者），并严重破坏医患个人和职业身份的认同感。围绕这些问题的冲突往往会在医院环境中被外化，在治疗过程中（患者与治疗师之间）以及病房群体中（患者与病房工作人员之间，以及主治医生与病房工作人员之间）形成典型的冲突模式。本文通过两个案例——两位患有精神病且有自杀倾向的医生——探讨了这些冲突和互动模式的表现，尽管抵抗和外化模式呈现出不同形式，但都表达了相同的潜在问题。
