Predisposition to emotional distress and psychiatric illness amongst doctors: the role of unconscious and experiential factors.

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  • Author(s): Johnson WD;Johnson WD
  • Source:
    The British journal of medical psychology [Br J Med Psychol] 1991 Dec; Vol. 64 ( Pt 4), pp. 317-29.
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't; Review
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: British Psychological Society Country of Publication: England NLM ID: 0370640 Publication Model: Print Cited Medium: Print ISSN: 0007-1129 (Print) Linking ISSN: 00071129 NLM ISO Abbreviation: Br J Med Psychol Subsets: MEDLINE
    • Publication Information:
      Publication: Letchworth Eng : British Psychological Society
      Original Publication: London [etc.]
    • Subject Terms:
      Physician's Role* ; Psychoanalytic Theory* ; Unconscious, Psychology*; Affective Symptoms/*psychology ; Mental Disorders/*psychology ; Occupational Diseases/*psychology ; Physicians/*psychology; Alcoholism/psychology ; Depressive Disorder/psychology ; Humans ; Marriage/psychology ; Personality Development ; Substance-Related Disorders/psychology ; Suicide/psychology
    • Abstract:
      This paper explores the contribution of unconscious and experiential factors in accounting for the high rates of depression, alcohol and drug abuse and suicide within the medical profession. The first part of the paper reviews the literature on motivations to study medicine and proposes that, for some doctors, a component of their decision is a response to unconscious drives to compensate for childhood experiences of parental impotence, or emotional neglect. The second part of the paper utilizes the theoretical framework of Kohut to argue that these childhood experiences may also result in the development of a narcissistic disturbance, and a vulnerable self-esteem. A model is outlined of how this may contribute to the development of emotional distress and psychiatric illness through the creation of a state of dependence on patients, emotional detachment and the denial of personal vulnerability. It is proposed that preventative strategies will need to include changing the emotionally 'abusive' nature of medical education, which tends to exacerbate this process.
    • Number of References:
      64
    • Publication Date:
      Date Created: 19911201 Date Completed: 19920323 Latest Revision: 20191210
    • Publication Date:
      20231215
    • Accession Number:
      10.1111/j.2044-8341.1991.tb01670.x
    • Accession Number:
      1786225