PSYCHIATRIC PATIENTS' SELF-IMAGE AND STAFF FEELINGS TOWARDS THEM RELATED TO GENDER COMBINATIONS

Abstract

Psychiatric patients' influence on therapists' feelings has received much clinical attention but scant interest among empirical researchers. In this study, the staff at 25 small psychiatric treatment units for mainly psychotic patients reported their feelings towards the patients twice a year over 5 years. At intake, the patients completed the self-rating version of the Structural Analysis of Social Behavior (SASB) protocol; a circumplex model intended to capture internalized perceptions of self and others. The instrument included ratings of the introject and ratings of how the individual remembered that mother and father had treated him or her in childhood. Correlations between the patients' SASB scores and the staff members' average feelings towards the patients were assessed. The associations varied in the different gender combinations, but some overarching patterns were found. Patients scoring high on both the spontaneous and the controlling introject evoked accepting staff feelings, and patients reporting low scores on both these SASB aspects evoked rejecting feelings. These associations were interpreted as reflecting influence from the patients' engagement in and struggle with themselves on the treatment process. Staff identification with a parent figure was particularly evident in the female staff–male patient combination, where the patient's positive image of mother was associated with positive staff feelings towards the patient.