Psychiatric Quarterly

, Volume 88, Issue 4, pp 675–686 | Cite as

The Patient-Psychiatrist Relationship on the Axis of the Other and the Same

  • Gabriel Schreiber
  • Sofia Avissar
  • Alan Jotkowitz
  • Demian Halperin
Original Paper
First Online:

Abstract

The patient-psychiatrist relationship is a cornerstone of psychiatric professionalism and ethics. We discuss this topic along the axis of the Other and the Same, concepts defined by continental philosophy. The self of Anglo-American philosophy is typically described in individualistic terms. Individualism, autonomy and ideal self are valorized within the current model of care. These characteristics belong to the Lacanian Imaginary Order, which is the core of narcissism. Patients may yearn for another model of interaction. For Levinas, ethics should not involve a search for perfectionism and accomplishment but responsibility toward others. Ethics is, according to him, rooted in the calling into question of one’s Sameness by the other’s Otherness. The question of hospitality and of the welcoming of Otherness is central to his thought. Derrida further asks whether hospitality is not an interruption of the self. Hospitality may thus become a fundamental way of re-thinking clinical practices. A relationship to the Other as an-other is characterized as of Euclidian-type, establishing borders between the self and the Other, whereas a relationship to the Other as same is characterized as of fractal-type, emphasizing similarities between self and other as same and obliterating boundaries. Winnicott’s object-relating versus use of object and Buber’s I-you and I-it relations are also examined along the axis of Sameness and Otherness. Since psychiatric clinical practice requires to our view adequate and adaptive to and fro movements along this axis, the two forms of relating to the Other are discussed both theoretically and through a clinical case presentation.

Keywords

Patient-psychiatrist relationship Ethics Professionalism Hospitality Otherness Sameness 
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Notes

Compliance with Ethical Standards

For all authors, no conflicts of interest are declared.

Research Involving Human Participants and/or Animals

No human participants or animals.

Informed Consent

Not required.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Gabriel Schreiber
    • 1
    • 2
  • Sofia Avissar
    • 3
  • Alan Jotkowitz
    • 4
    • 5
  • Demian Halperin
    • 1
    • 2
  1. 1.Department of PsychiatryBarzilai University Medical CenterAshkelonIsrael
  2. 2.Division of Psychiatry, Faculty of Health SciencesBen Gurion University of the NegevBeer ShevaIsrael
  3. 3.Division of Clinical Biochemistry & Pharmacology, Faculty of Health SciencesBen Gurion University of the NegevBeer ShevaIsrael
  4. 4.Department of Internal MedicineSoroka Medical CenterBeer ShevaIsrael
  5. 5.Division of Internal Medicine, Faculty of Health SciencesBen Gurion University of the NegevBeer ShevaIsrael

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