Working in a world of bodies defensive techniques on a medical ward — A psychoanalytical observation

SUMMARY

This paper describes the observation of a medical ward carried out in a general hospital in weekly visits over a period of four months, and attempts a psychoanalytic understanding of the observations. Nurses working with physically ill patients face deep anxieties and conflicts, particularly fear of death and illness, of being overwhelmed by their feelings of pity, guilt and resentment; but also fear of the sexual impulses that close physical contact with patients stirs up. The paper shows that these anxieties were dealt with by a number of defensive techniques. Although the nurses sometimes showed the ability to be sensitive, the general culture was very defensive. The various defensive techniques commonly used are described and illustrated. Amongst them were: manic excitement and erotisation; a constant moving of patients with little recognition of their feelings about that; a strong use of the body, so that patients were often not related to as whole persons; and defence mechanisms of a particularly concrete kind.