主治医に特別な感情をいだいていませんか？精神科医が語ります。16分動画

Good evening. I'm Haga Takahiro, a psychiatrist. Today, I've brought along a slightly new theme that I'd like to discuss with you all. What I'd like to discuss today is whether you have any special feelings toward your doctor. The reason I want to talk about this is that recently—well, actually, a little while ago—one of our patients who transferred to our hospital was extremely concerned about the fact that things hadn't worked out with his previous doctor. There are, of course, many reasons for transferring hospitals. Some patients transfer because of a change in environment, like moving, while others transfer simply because they were dissatisfied with their medical care. However, there are a certain number of cases where the relationship ends with a tangled web of emotions. And there is something to be learned from such cases. If you can learn from them and apply what you've learned in the future, you can "heal" your separation from your doctor. In fact, it can even turn into a positive event that helps you move forward. So today, I'd like to ask you this question: "Are there any special feelings building up in your relationship with your doctor?" A common pattern is the combination of a male doctor and a female patient. This is simply because there are still more male doctors than female patients. I graduated from medical school 20 years ago, and at the time, the medical staff was about 55% male and 45% female, meaning it was a generation with a significantly higher female predominance. Even so, overall, there are still more male doctors than female doctors. The gender ratio among psychiatric patients is not extremely skewed, but from my experience, I have the impression that the type of patient with "mixed emotions and complicated relationships" is more common among female patients. Among male patients, there are a certain number, for example, who have schizophrenia and are highly autistic, meaning they don't have much interpersonal conflict to begin with. Of course, there are individual differences. By the way, I don't think I've ever had a relationship with a patient that was a "mixed love-hate" relationship. I apologize for saying this myself, but I am careful, and I try to carefully create a treatment framework from the beginning to make it less likely that kind of atmosphere would develop. Unfortunately, there are some doctors out there who lose their sense of distance from their patients. That's why it's important to understand what emotions can arise. Broadly speaking, the first pattern is when a patient sees their doctor as "the opposite sex." In other words, they see the doctor as cool or attractive, either as a man or a woman. This is understandable, after all. Being a doctor is a profession where it's easy to appear "cool." It's not that they want to sound cool themselves, but as a profession, it's easy to get that kind of advantage. They appear intelligent and experienced. Furthermore, visiting a psychiatrist means that the other person is ahead of them in their "field of interest." Even at work, when a new employee is still learning their trade, they might see their boss as cool when they see him or her hard at work. In the same way, having someone who guides you in the field of psychiatry can sometimes give rise to feelings close to admiration. There's also the influence of dramas, a kind of white coat magic. Up to this point, this isn't necessarily unhealthy. In fact, there are cases of doctors and patients getting married. One of my seniors from my internship married a patient who was hospitalized. They are still happily married today. However, if they become romantically involved, it is best to exclude the attending physician from the treatment process. This is for the safety of the treatment. The second pattern is even more problematic. In this case, the patient desperately wants special treatment and 100% commitment, so they try to attract the attending physician's attention through sexual advances or flirtation. Chronic suffering leads to a desire for relief. The desire for attention and more care grows stronger. I understand this feeling. However, sacrificing oneself to get attention is not healthy, and ultimately, treatment will not work. The reason is that treatment has a "framework." You can't contact the doctor at night, you can't make an appointment right away, and even if your medication is about to run out, you have to hold out for a week until your next appointment. While this "inconvenience" can be painful, it can also strengthen patients. It gives them time to think for themselves and can help develop self-healing abilities. However, if a patient's doctor treats them specially and is available 24 hours a day, 365 days a year, the patient loses the opportunity to develop the ability to "walk independently." Dependence deepens, and the doctor becomes like a "boyfriend." As a result, some doctors may dispense more medication when asked. This leads to a breakdown ...