The Seductive Patient

One of the most difficult types of patients for the novice to interview and examine is the seductive patient. In many ways, it is more difficult to deal with the seductive patient than with a hostile patient. Many of these patients have one of the personality disorders (e.g., histrionic, narcissistic) and harbor fantasies of developing an intimate relationship with their physician. These patients are often attractive and tend to be flashy in the way they dress, walk, and talk. They commonly offer inappropriate compliments to the interviewer to gain his or her attention. The patients are frequently emotionally labile. Not uncommonly, these patients expose themselves physically early in the interview. The interviewer may elect to cover the patient, but usually this is unsuccessful, as the patient may expose him/herself again. It is difficult for the interviewer to cope with his or her own feelings when he or she is attracted to such a patient. The feeling of attraction is a natural one, and the interviewer must accept it. However, the interviewer must always maintain a strictly professional demeanor. Empathy and reassurance must be kept to a minimum because these supportive techniques stimulate further fantasies in the patient. The interviewer must always maintain professional distance. It may be necessary to say, ''Thank you for your nice compliments, but in order for me to help you, we must keep our relationship strictly professional. I hope you understand.'' If necessary, the interviewer should get the advice of someone he or she trusts.

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