Pauline Pytka MD, FRCPC

Medical care in general, and psychiatry specifically, has shifted from the principle of easing suffering to specific ‘approaches’ to the diagnosis and treatment of illness. It is easy to forget that we are really fundamentally trying to ease another person’s suffering. 
Donna Orange, a philosopher and psychologist has a beautiful passage in her book “The Suffering Stranger: Hermeneutics for Everyday Clinical Practice”. I suppose in a way it’s not that different than Maimonides  “May I never see in the patient anything but a fellow human in pain.”
I feel it’s very poetic:
“ Commitment to relief of suffering as our fundamental therapeutic vocation has several corollaries, which scarcely need stating as they are so obvious, so I will be brief: 
1. A compassionate attitude of suffering with the other is indispensable. 
2. A dialogical, non-authoritarian style is equally crucial. One can support without becoming an expert-authority. 
3. Consistency and reliability, not a propensity to wear ourselves out, are essential to working with the profoundly traumatized. 
4. We should expect to be affected by our work to the core of our being and sometimes to feel retraumatized.
 5. We need our own supports, and sources of nourishment and hospitality, if we are to continue. 
Finally, it seems important to note that our ethical response coincides exactly with our clinical vocation to restore dignity to devastated, shame-filled, degraded, and suffering human beings like ourselves.
In my view, treating the other as a worthy partner in dialogue—no matter what distress or symptoms the patient brings to the encounter, and no matter what aversive preconceptions the clinician carries or develops—creates the foundations for working within what we designate here as the hermeneutics of trust. 
Everything we can learn from every school of psycho-analysis and psychotherapy, as well as from other disciplines and from the arts, that helps us to meet and sustain the suffering other non-evasively, without too much suspicion, is both good healing therapeutic practice and good ethics”.
Donna M Orange The Suffering Stranger:Hermeneutics for Everyday Clinical Practice Routledge, New York, London 2011 p69-70
Donna Orange is Clinical Assistant Professor of Psychology at New York University and teaches at the Institute for Psychoanalytic Psychology of the Self and Relational Psychoanalysis, Milan and Rome. In New York, she teaches
and supervises at the Institute for the Psychoanalytic Study of Subjectivity.
 Emotional Understanding: Studies in Psychoanalytic Psychology.
Thinking for Clinicians: Philosophical Resources for Contemporary
Psychoanalysis and the Humanistic Psychotherapies.
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