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October 1963

Studies of the Special Patient: The Sentence

Author Affiliations

From the Psychiatric Liaison Service and the Henry Phipps Psychiatric Clinic, The Johns Hopkins Hospital.
Instructor in Psychiatry (Dr. Pollack) and Fellow in Psychiatry (Dr. Battle).

Arch Gen Psychiatry. 1963;9(4):344-350. doi:10.1001/archpsyc.1963.01720160034004

Introduction  Strange and disturbing is the state of affairs in which a nurse or physician shows signs of sharing a patient's illness in such a way that therapy is undermined and rapport with the remainder of the staff begins to crumble. This "ailment" was brilliantly described in an article by T. F. Main6 in which he drew attention to a category of patients, all of whom are women, whose hospital stay is marked by a pronounced loss of objectivity on the part of various staff members with whom the patient has formed intense, exclusive, and mutually harmful relationships. Typically, these patients have some close social, professional, or familial connection with members of the medical community. Their admissions are heralded by intense and unusual appeals from the referring physician for special consideration of the case. The usual history of self-destructive behavior and failure to improve in

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