This process takes place continuously while a doctor is consulting but needs to be practised for full advantage to be gained. There are two elements. First, recognition of the feelings in the doctor engendered by the patient may help him or her to understand the patient’s problems, particularly if a problem involves a relationship with another person. In Chapter 1, Elphis Christopher describes beautifully how the process of becoming entangled with the patient’s problem allows feelings in the doctor to surface. Freeling and Harris (1984) categorize the doctor’s feelings into those that are unconnected, indirecdy connected and direcdy connected. Unconnected feelings can arise from the doctor’s own domestic problems or from an emotion aroused by the last patient seen. Indirectly connected feelings may arise when the doctor identifies a problem he or she has experienced, such as a marital or sexual difficulty. Both of these categories of feeling lie strictly in the domain of the doctor’s personal life. Directly connected feelings may be used legitimately in the consultation. Training in psychosexual medicine helps doctors to appreciate when it may be appropriate to feed these back to the patient. However, this must be done carefully and sensitively. This skill is an intuitive one which is a far cry from the conventional history-taking type of consultation that many doctors were taught at medical school.


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