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BACKGROUND: A growing body of evidence indicates that health care professionals working with severely ill patients are in need of support. Beside "external" factors, such as heavy clinical patient volume or administrative duties, "intra-psychic stressors," related to the inner significance of contextual factors, are an important source of clinician's distress. Identification of and working through intrapsychic stressors can considerably reduce psychological distress and thus provide effective and long-lasting support of the oncology clinician.

PURPOSE: This article discusses key elements of intra-psychic stressors, namely (1) emotions towards the patient, (2) awareness of own limits, (3) confusion about empathy, identification, counter-transference and collusion, (4) the influence of early development and life trajectory on career choices and professional identity and (5) the conflicting roles a health care professional being in need of support has to face.

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