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Mutuality in nursing leads to vulnerability for patient and nurse in a psychotherapeutic community This paper was written whilst the author was doing the Cassel Hospital course in psychosocial nursing and was written following a particularly difficult weekend duty experienced at the Cassel Hospital. The social defence systems used in general nursing are compared with those used when nursing in a psychotherapeutic community. In such a community staff, especially nurses, by the very nature of their work, meet their patients at a more mutual level, and this can hopefully help to examine anxiety-provoking situations more honestly, to the greater benefit of the patient.

'Mutual', in this sense, refers to a reciprocal relationship which relies on a refined sensitivity in emotion and taste, quickness and acuteness of apprehension and feeling, and a readiness to feel compassion that is not just pity but a complete blend of empathy and understanding. It does not rely on equality, but this absence of equality need not lead to feelings of inferiority on one side and superiority on the other. This kind of‘mutuality’inevitably leads to vulnerability of both nurse and patient and, to be able to use experiences to enable growth, a strong support system becomes necessary.