Listening to what the patient does not tell us

In the intimacy of outpatient psychotherapy, the psychiatrist's ethical responsibility (burdensome at times) is always to place the emotional priorities of the patient ahead of the therapist's external and internal agendas. For example, the therapist's schedule (anticipated vacation), the therapist's interest in the patient for the sake of a publication, presentation, teaching, have to be subordinated to the emotional and somatic vulnerabilities and needs of the patient. The only sensor for this interaction is the professional conscience of the therapist. Excerpts from psychotherapy with six patients will highlight the dilemmas which each patient had which forced them to camouflage their hurts from themselves. An attempt will also be made to highlight ethical and professional dilemmas of the therapist.