The making of a doctor: the matrix and self

Abstract

Foulkes’ concept of the matrix, the hypothetical web of communication, has long since left the consulting room and entered the wider sphere of communities, countries, and institutions. This article will discuss how the matrix encompasses a whole profession, that of medical doctors. Together with a deep-rooted sense of identity, which I refer to as the medical self, the medical matrix contributes to doctors’ professional wellbeing but also begins to explain the enormous recent increase in mental illness in the medical profession seen across the world. The article focuses on doctors. However, the ideas are relevant to any group (for example, teachers, the clergy, psychotherapists) which has a strong personal and professional identity, with all its attendant privileges and problems.

NHS frontline staff experiences of an in-house psychological support service during the COVID-19 pandemic

“…Peer support has been described as beneficial and important to healthcare staff (Gerada, 2019;Jackson, 2018) and may be preferred by some people who may not want to burden those around them, such as their family (BPS, 2020;Billings et al, 2020b). Participant's here described feeling connected with and more willing to support others after accessing the service.…”

Setting the Limits of Consultations

“…It is another threat to the 'medical self'. 3 Perhaps this can be helped if we can establish the consequences and the academic community should step forward to consider: What are the true costs of longer appointments and limiting contacts and consultations? What are the potential benefits of capping GP workloads on recruitment and retention?…”

Groups for the dead

“…Given doctors’ shared education, historical, cultural, social and linguistic experiences, they have their own foundation matrix. Gerada (2019) has written about the doctor’s matrix and how this acts to create group norms, among which are: doctors must not become unwell and do not show their vulnerabilities; they do not admit to being unwell; and they deny their problems. These norms, created by the dead and re-learnt by the living, ensure doctors do the work demanded of them and develop the defences needed to face suffering, disease and disability without breaking down.…”