The Role of Self-Reflection (and Reflective Supervision) in the Development of Psychiatric Residents

Martin Kommor, Invited address at The Julian Jaynes Society Conference on Consciousness and Bicameral Studies, Charleston, WV, June 2013.

Abstract: Psychiatry especially since Freud has emphasized the importance of insight and the practice of self reflection (SR) whether for patients undergoing talking therapy or residents undergoing training. Does SR, however, help residents become better clinicians? How so? In what fashion? It may be by enhancing empathy. It’s been demonstrated that a) medical students become less empathic as they go through medical school and b) that clinicians perceived by their patients as highly empathic are more likely to achieve patient compliance in the management of chronic illness. Does more SR produce more empathy? How? Do residents in fact get training in SR? What exactly do we mean by SR? By SR training? How does SR compare to empathy, introspection, meditation and more recent concepts like mentalization or reflective function? How and when does SR occur over the life span? What promotes its development? What interferes with it? How does it “work” neurophysiologically? These are some of the questions I will be addressing during this presentation. Some I hope to answer thoroughly. Others will be more speculative if not sketchy. Nevertheless, I hope to stimulate your curiosity on this subject. It certainly has stimulated mine.

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