Psychodynamic aspects of communication skills training: a pilot study.

Goals of Work: Communication between patients and oncology clinicians is a key element of cancer care. Emotionally charged consultations may trigger clinicians' defense mechanisms, protecting them from painful emotions. Defense mechanisms, however, may also hamper the recognition of patients' suffering. This pilot study aims to explore clinicians' defense mechanisms observed in communication skills training (CST).
Patients and Methods: A verbatim transcription of videotaped interviews with simulated patients were evaluated before (N=10) and after CST (N=10) with the defense mechanism rating scales (DMRS).
Main Results: A wide variety of defense mechanisms were observed such as obsessional (e.g. intellectualisation) or disavowal (e.g. denial or projection). Immature defense mechanisms decreased after CST.
Conclusions: A wide variety of defense mechanisms are operant in oncology clinicians facing challenging interviews with simulated patients. Defense mechanisms may be modified by CST.