“I’m a genetic mistake”: the woman who wanted to be her doctor

Kate Moss Psychoanalytic Psychotherapist Genetics and Women’s Dermatology

St. John’s Institute of Dermatology St. Thomas' Hospital

London katharine.moss@gstt.nhs.uk +44 (0) 207 188 7841

“I’m a genetic mistake”: the woman who wanted to be her doctor

How do we broach the topic of desire with our visibly different, sometimes Untouchable,

patients? Whose job should that be? Our patient became increasingly mentally unwell as intimations of mortality loomed: severe

RDEB typically produces aggressive squamous cell carcinomas and death in early midlife. While off the scale in my experience of psychiatric comorbidity in EB, her contested

diagnosis proved insufficient to invoke continuing community mental health input, leading to revolving door emergency presentations and hospital hopping. This did not provide what the patient sought, and tended to alienate professionals. I will suggest that we could learn from Rosenhan’s work on perceptions of madness and sanity.

Insistent themes of sex and death tested the many teams involved and prompted some

fruitful soul-searching on the topic of desire and disability, a lifelong issue for many people with visible differences.

Severe generalised RDEB

http://www.outsiders.org.uk/ Accessed 5.9.14

‘[The delusion].. is found like a patch over the

place where originally a rent had appeared in the ego’s relation to the external world.’

Freud, S. (1924) Neurosis and Psychosis, SE 19. p.151.

‘…the delusional formation which we take to be the

pathological product, is in reality an attempt at recovery, a process of reconstruction’

Freud. S. (1911) Psycho-Analytic Notes on an Autobiographic Account of a Case of Paranoia (Dementia Paranoides), SE 19. p.70

Medea about to Kill her Children by Eugene Delacroix, 1862 Oil on canvas 122 x 84 cm Musee du Louvre, Paris.

David L. Rosenhan, Professor of Law and Psychology, Emeritus, Stanford University (1929 – 2012)

The flesh is bruckle The Fiend is slee Timor mortis Conturbat me William Dunbar

‘[We understand]..that.. in England and Wales

making a direct referral to a sexual surrogate is very unlikely to constitute a criminal act.

However, an offence may be committed where a [person] causes or encourages someone.. not already working as a sexual surrogate to become one.’

3.3.10 Code of Ethics, College of Sexual and Relationship Therapists http://www.cosrt.org.uk/wp-content/uploads/2012/10/3_code_ethics_members.pdf Accessed 3. 9.15

All T-shirts: http://marius.sucan.ro/propaganda/physical-disabilities-do-not-include-intelectual-disabilities Accessed 5.9.14

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