Experiences of selves in isolation: A psychodynamic approach to the care of patients being treated in a specialized medical hospital unit1

Abstract

In this paper, I explore the emotional experiences of patients who are nursed in physical isolation in a specialist general hospital. I begin with a description of a subjective experience that occurred while I was in a session with a patient. My own inner psychic state led me to think about what the patient might be feeling and it became the basis for the subject of this paper. With reference to the work of Daniel Stern, Thomas Ogden and others I discuss the possible effects of a serious physical illness and its treatment on the patient's sense of self and bodily continuity. Insight into the mental, physical and emotional processes that may affect these patients can help the counsellor to work with the kinds of anxieties that arise and provide the emotional containment needed. The patients written about in the three clinical examples were all in-patients being treated for leukaemia. The ideas explored here can also apply more broadly to include other seriously ill patients needing intensive medical treatment in hospital.