Supportive Psychotherapy: The Nature of the Connection to Patients

To the Editor: As I read the article by Carolyn J. Douglas, M.D. (1), published in the April 2008 issue of the Journal, I recalled the words of a colleague who recently spoke to me about a mutual patient and emphasized that after four decades of practicing psychotherapy, he had concluded that the connection to a patient was the most essential element in working with patients, no matter what their condition. This colleague is a classically trained psychoanalyst and child psychiatrist who mostly treats adult patients.

I applaud Dr. Douglas’ masterful exploration of the difficulties, ambiguities, and opportunities in psychotherapy practice in general, and specifically in exploring the nuances of these challenges and possibilities in the field of supportive psychotherapy. She provided superb and jargon-free explanations of the nature of supportive psychotherapy and the inherent controversies the field entails. Most important, she brought clarity to what the nature of the connection needs to be with our patients in order to be effective and what teachers of psychotherapy need to appreciate in order to supervise psychiatric residents.