ABSTRACT
The recent announcement by the high profile actress, Angelina Jolie, that she had had a preventive double mastectomy because she had a high genetic risk of breast and ovarian cancer will lead other women who are at risk to consider similar operations. Psychiatrists and other physicians are likely to be asked to advise women concerning this decision. This column discusses the psychological impact of mastectomy and breast reconstruction for women and encourages clinicians to have an empathic and understanding attitude and allow patients to talk openly about their fears, doubts, concerns about sexual intimacy, and other issues. It is also important to let women experiencing psychological reactions to mastectomy know that such feelings are normal and usually recede in time.
Subject(s)
Breast Neoplasms/prevention & control , Famous Persons , Mastectomy/psychology , Adult , Breast Neoplasms/genetics , Female , Humans , Mammaplasty/psychologyABSTRACT
Special challenges face the 21st century teacher of psychodynamic psychotherapy. Time for careful psychodynamic reflection, of necessity, competes for space with the current explosion of psychiatric knowledge in psychopharmacology, genetics, health care policy and multiple other agendas. Thus educators must be clear about the goals of psychodynamic psychotherapy, engage students in the special interviewing techniques to elicit sensitive information and appreciate the special needs of today's physicians launching into this field. Educational objectives must be clear, the goals of psychoanalysis and psychoanalytic psychotherapy well articulated and the means to gather information enhanced. With the expansion of neuroscience into the mysteries of implicit and explicit memory this is also an area where the 21st century educator must develop integrative expertise. There are tools available to expand ones proficiency in each of these areas.
