PubMed · 1809923
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M Wright. The games nurses play.. https://pubmed.ncbi.nlm.nih.gov/1809923/
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Although we are now less inclined to argue about whose treatment is entitled to be called psychoanalysis, we will understand current debates better if we revisualize what originally made psychoanalysis different from other treatments. At its birth, psychoanalysis twisted the common-sense treatments it grew out of into very peculiar shapes. In reaction to that extreme peculiarity, a process of normalizing began almost immediately and continues to this day. This process is illustrated by tracing the rise and fall of peculiarities in four aspects: medical procedure, the analyst's vision, the analyst's role, and the sense of time.
Games are defined as ongoing series of complementary ulterior transactions that are superficially plausible but have a concealed motivation to maximize pay-offs and minimize penalties for the initiator. While some games are harmless and part of socialization, others are destructive. Destructive game-playing in clinical supervision, in which game-playing (initiated by either supervisors or students) interferes with a student's realization of internship goals, has been documented in some allied healthcare professions but has not yet been studied in genetic counseling. Genetic counselors and clinical supervisors of genetic counseling students were anonymously surveyed regarding their experiences with destructive game-playing. Results show that such games do occur in genetic counseling clinical supervision. Some games are the same or similar to ones previously described in other health-care professions; others may be unique to genetic counseling. The purpose of this paper is to document these games as a first step to facilitating dialogue, understanding and awareness of them.
The defense mechanism of splitting appears to underlie many interpersonal problems that are presently classified within the category of relational disorders of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) and, accordingly, bridges individual and family psychology. It is suggested here that certain relationships are marked by specific patterns and characteristics that can best be regarded as dyadic splitting. This article presents an overview of splitting in individuals and couples and reviews empirical studies establishing norms and validity of dyadic splitting, as measured by the Dyadic Splitting Scale. Research with samples of men who batter, battered women who return to their abusers, and couples clinically assessed as being narcissistically vulnerable demonstrates the presence of dyadic splitting in these populations. The notion of a defense mechanism influencing relationship dynamics strengthens the appreciation of mutuality between individual and relationship disorders and holds promise for treatment.