Physicians’ “compliance with treatment” in the context of consultation-liaison psychiatry: The role of “triangle” relationships and projective identification

Transference and countertransference issues arising in the context of consultation-liaison (C-L) psychiatry could be more complex than originally assumed since they include reactions evoked within the frame of a unique “therapeutic triangle” of the patient, the physician, and the C-L psychiatrist. A clinical vignette illustrates how the projective identification process could mediate the relationships between the members of the therapeutic triangle through the different transferences and countertranferences interwoven in the setting of C-L psychiatry. This, if left unchecked, may result in the disruption of professional relationships and in jeopardizing the treatment of patients.