Interpersonal Aspects of Psychiatric Consultations in a General Hospital

Abstract

Interactions between referring physicians and psychiatric consultants are crucial issues in the overall care of the patient in the general hospital. This presentation concerns itself with these issues, in particular the types of referrers and consultants involved in the consultation process. Psychiatrists are often ineffective as consultants if they are unable to communicate with referring physicians because of inflexibility and are unable to explain the patient's behavior in terms meaningful to the physician. Likewise the referrals are ineffective if the physician calls in the consultant only after all other diagnoses are considered and if emotional illness is presented in a disparaging manner. Because of the patient's unconscious use of somatic defenses and denial of emotional conflict, care must be taken not to reinforce resistances toward a psychosocial approach to his illness.