Regression in the service of residency education

Regression as a potentially adaptive psychological response is used as a conceptual model to understand a variety of behaviors seen in beginning psychiatric residents on an inpatient service. The behaviors, discussed and illustrated with brief examples, are (1) competition and identification, (2) sexuality, (3) aggression, (4) depression and despair, (5) dependency, and (6) fusion with patients. Factors on an inpatient service that foster regressive behavior in new residents are discussed, and some of the potential resolutions of the behavoirs are proposed. Regression is seen as an adaptive experience for most residents; with appropriate supervisory intervention, it can foster cognitive development.