Psychiatric residents and lower class patients: Conflict in training.

A special outpatient clinic was established to pioneer newer and more appropriate methods of treating poor personality resource patients. While the clinic apparently served its clientele, the psychiatrists in training felt angry and frustrated in their clinic experience. Analysis of interview data revealed that the trainees were subject to forces that placed them in conflict. The characteristics of the patients, the clinic structure that required subservience of individual gratifications to institutional values, the need to develop a personal sense of competence, and the residents' perception of conflicting values on the part of the staff all contributed to the residents' experience of conflict and frustration. Patterns of conflict resolution were discerned in criticism directed toward the staff but more effectively in apathetic withdrawal of personal investment.