title: Reflexivity and countertransference in a psychiatric cultural consultation clinic.
abstract: A Mexican-American woman who complained of persistent head pain and a bothersome "voice" was seen by a team consisting of a psychiatrist, social scientists, and spiritualist healers in a Cultural Consultation Clinic of a Psychiatric Consultation Liaison Service. This single case is analyzed to provide an understanding of the interpretive dimensions of psychiatric practice. It is argued that a hermeneutic analysis of clinical phenomena focuses attention on three distinct aspects of interpretation: on the interpretation by clinicians and clients of the discourse of the other in terms of their own clinical models; on the influence of deeply embedded personal meanings on this interpretive process; and on the role of the observer in clinical ethnography. It is argued that to sustain a hermeneutic analysis of psychiatric practice, an account of transference and countertransference in terms of interpretation theory will have to be developed.
mesh_terms: D000328:Adult; D000884:Anthropology, Cultural; D002140:California; D003156:Community Mental Health Services; D003379:Countertransference; D003466:Cultural Characteristics; D003469:Culture; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008602:Mental Healing; D008800:Mexico / Q000208:ethnology; D011570:Psychiatry; D011602:Psychophysiologic Disorders / Q000628:therapy; D012017:Referral and Consultation