
Contents
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Introduction: Cracks in the Frame Introduction: Cracks in the Frame
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Twenty Years Ago: Recollections of an Illness During Residency Training Twenty Years Ago: Recollections of an Illness During Residency Training
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Twenty Years Ago: Turning to the Literature Twenty Years Ago: Turning to the Literature
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Ten Years Ago: A Frame within a Frame (Within a Frame) Ten Years Ago: A Frame within a Frame (Within a Frame)
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Ten Years Ago: Clinical Vignette Ten Years Ago: Clinical Vignette
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Present: Reflections Present: Reflections
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Note Note
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References References
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8 When the Frame Shifts: A Multilayered Perspective on Illness in the Therapist
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Published:May 2013
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Abstract
This chapter considers how illness in the therapist affects the frame of the treatment. The author describes the onset of a debilitating and mysterious illness that interfered with her work as a psychiatrist, both as a therapist and as a supervisor. It took many long months to receive a diagnosis, during which time she experienced fear, isolation, and confusion. She relates a disruption in her sense of personal and professional identity, one that profoundly derailed her long-anticipated professional trajectory. Suddenly, she felt she no longer knew what her future would hold. While her illness is invisible to others, its presence leaves an indelible trace. In the countertransference, she becomes aware of holding on to the idea that her recovery is just around the corner, which keeps despair at bay but at the same time keeps her patients on hold too long, with diminished therapeutic benefit. Importantly, she points out that “crisis also breeds intensity of attachment: those who are nearby and empathic at a time of tragedy in one's life become especially important to us.” This observation also sheds light on the many ways in which therapists may find themselves holding on to patients too long.
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