Rationalization is also brought to bear. The physician does not wish to encumber his colleagues with his problems as they have enough of their own being already fully scheduled and over-worked. Rationalization and omnipotence nourish one another, and what Oppenheimer 13 described as a self-sealing system develops. From the interpersonal standpoint, there is the major problem of stigma. The stigmatization of emotional disturbance and its sufferers is an inescapable fact of life in our culture.
Insurance companies rate the emotionally disturbed.
The next interpersonal problem is our relationship to our colleagues. Though we may feel we can identify at times aspects of behavior in another which raises serious questions, we hesitate to act. Many of us are perhaps uncertain as to where the line is drawn between idiosyncratic behavior and frank emotional illness. Further, there are risks and liabilities associated with pointing things out either to the affected individual or to others. Such identification could result in stigmatizing labeling, imposition of practice sanctions for the colleague or perhaps even lawsuits or slander actions against the informant, particularly if the colleague is in a competing specialty.