This patient’s hostility and need to be in charge had alienated one doctor and provoked him into retaliation. Uncharacteristically, he had told her that he would not do what she wanted; he had met her aggression with an attack by telling her she did not know what she wanted. He was right, but had not understood why, and had used her age as a ‘reason’ for refusal. The failure to examine what was behind her demand led to more determination on her part to get what she wanted – a release from her difficulties within her relationship which she had inappropriately focussed onto the Pill. The second doctor had recognized the hostility and the need to be in charge and had become, also uncharacteristically, diffident and tentative, while still remaining ‘in charge’. Rather than challenging head-on, the doctor tried sneaking in round the back by allowing the patient to explain her reasoning. Only when Mrs J. was able to explain the circumstances behind her demand could she begin to see that what she was doing was illogical. She could then appreciate that her difficulties could not be solved by a change in her method of contraception but only by changes in her relationship with her husband.
*302/197/1*