A Portrait

Review of The Place of Dynamic Psychiatry in Medicine by H. H. Wolff. Ipswich, Society of Clinical Psychiatrists, 1970

British Journal of Psychiatry, 117, 1970, p. 454

What is the dynamic psychiatrist? He is skilled in he basic biological sciences and also in the various behavioural sciences, including psycho‑analysis, psychology, learning theory, sociology and social anthropology. He has some degree of self‑awareness, he understands his own personality, and he uses his own personality through consciously controlled empathy and involvement. He knows that a large proportion of illness is either of emotional origin or has important emotional consequences; he recognizes that a great deal of psychosomatic and psychiatric illness is the result of underlying personality disorders; be understands the way in which disturbances during childhood development, especially in the parent‑child relationship, and conflicts concerning aggression and sexuality, may lay the basis for abnormal vulnerability to stressful experience in later life.

   What does the dynamic psychiatrist do? He approaches each individual as a psychobiological entity inseparable from and constantly interacting with his environment, He uses physical, including psycho­pharmacological, treatment methods and psychological, including psychotherapeutic, behavioural and social procedures, singly or in combination. He pro­vides these services to anyone suffering from organic disease, psychosomatic disonders, major psychoses (not so much), neuroses, personality disorders, psychological conflicts, personal problem and difficulties in human relationships. He is concerned with the whole of the patient's life situation and his attitude and reaction to it, with his own emotional reaction to the patient, and with the interactions of the team of which he is a member.

   He is attached to all the various medical, surgical and obstetric departments of his general hospital. He sees to it that the hospital is geared to dealing with the anxieties of patients and relatives, on admission and discharge, at test procedures, before and after surgical operations, before and after parturition, before and (relatives only) after death. He has regular meetings with the various medical and non‑medical, psychiatric and non‑psychiatric personnel, and holds seminars and group discussions with them. He is available in family planning clinics, infertility clinics and in gynaecological departments, making his psychotherapeutic skill available to women even before they become pregnant – not only the women but sometimes also their husbands. He is ready to help in child guidance clinics, centres for adolescents, and elsewhere, where all, adults too, have easy access to social and psychotherapeutic facilities. He visits a group practice once a werk to help the general practitioners with their current problems, and he is ready to assist them with their own psychotherapeutic work by means of regular seminars and case discussions. He helps the social workers with their case‑work.

   He does a tremendous reaching job with junior psychiatrists, post‑ and under‑graduate students, medical and para‑medical staff of all kinds; and he is active in research. He exercises his formidable powers not only in all the above ways, but also in prophylaxis, promoting in all human relationships better comunication, a greater degree of mutual understanding and tolerance of each other's problems, preventing hate and rejection from taking the place of love and concern.