Intellectuality and emotionality in psychiatric residents

The fully trained psychiatrist must be able to integrate vast amounts of phenomenological data as well as to empathically share feeling states in patients. Beginning psychiatric residents often lean either towards intellectuality or towards emotionality, tendencies which potentially reinforce splitting within the profession. Cognitive styles may correlate with neurophysiological indicators, such as hemispheric dominance and the augmenting-reducing dimension. There may also be sex differences in cognition; if so, they would have to be taken into account as more women enter psychiatric training. A theoretical understanding of individual differences in students provides a basis for the pedagogical correction of biases. Overly intellectual residents may be organically or psychodynamically oriented. In either case they favour theory over concrete experience, and there are difficulties in mobilizing their empathic capacities. Identification with empathic teachers and a focus in supervision on the perception and integration of more stimuli, especially nonverbal cues, are important correctives. Overly emotional residents identify excessively with their patients and tend to have problems with boundaries. An augmenting tendency, leading to stimulus overload, can be controlled by teaching residents how to structure and set limits. Identification with the supervisor is sided by clear boundaries in the supervisory relationship. In both cases the resident's strengths must not be denigrated while correcting his weaknesses. Examples of learning problems in both kinds of residents are given, with discussion of supervisory pitfalls.