December 24th, 2011 by Dinah Miller, M.D. in Opinion
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When we talk about psychotherapy, one aspect of what we look at is the process of what occurs in the therapeutic relationship. This is an important part of psychodynamic-based psychotherapy, meaning psychotherapy that is derived from the theories put forth by Freud. Psychoanalysis (the purest form of psychodynamic psychotherapy) includes an emphasis on events that occurred during childhood, and a focus on understanding what goes on in the relationship between the therapist and the patient, including the transference and counter-transference.
In some of our posts, our friend Jesse has commented about how it’s important to understand what transpires in the mind of the patient when certain things are said and done. Let me tell you that Jesse is a wonderful psychiatrist, he is warm and caring and attentive and gentle, and he’s had extensive training in the analytic method, he’s on my list of who I go to when I need help, so while I want to discuss this concept, I don’t want anyone, especially Jesse, to think I don’t respect him. With that disclaimer…..
On my tongue-in-cheek post on What to Get Your Psychiatrist for the Holidays, Jesse wrote: Read more »
*This blog post was originally published at Shrink Rap*
November 20th, 2011 by Dinah Miller, M.D. in Opinion
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Psychotherapy is, by it’s nature, a narcissistic endeavor. That’s not to say that the patient is a narcissist, but the journey itself is meant to focus on patient’s interior life, and it’s not always about the greater good. In my last post, several commenters said they feel uncomfortable talking about themselves or worry that their therapist will mistakenly think they are narcissistic because they talk about themselves in therapy.
It’s not at all unusual for people to express some discomfort about talking about themselves in therapy, or to comment, “all I do in here is complain,” or “You must get tired of hearing people complain/talk about their problems, etc….”
I won’t talk for other psychotherapists because I only know how I feel. It seems to me that the mandate of therapy is for the patient to talk about the things they have been thinking about. The truth is that most people think about themselves, and issues of the world are interpreted by individuals as they impact them. Some people Read more »
*This blog post was originally published at Shrink Rap*
November 13th, 2011 by Dinah Miller, M.D. in Opinion
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We’ve been having a great discussion over on the post Tell Me…. An Ethical Dilemma. The post talks about a young man who wants to know if he can check “no” to a question about whether he has a psychiatric disorder if his illness is not relevant to the situation. The comments have been fascinating — do read them– and very thought-provoking.
One reader asked, ” If a patient asked if they were boring you, and they were, would you say yes?”
This is a great question, and of course the right thing to do is to explore with the patient what meaning the concern has to him. But is that all? I’m not very good at doing the old psychoanalyst thing of deflecting all questions, and mostly I do answer questions when they are asked of me. This can present a really sticky situation because one can not think of any clinical scenario in which it would be therapeutic to have a therapist tell a patient, ‘Yes, you’re boring, OMG are you boring,’ or ‘No, in fact, I don’t like you.’ And not answering could be viewed as negative response by the patient –if you liked me, you’d tell me, so clearly you don’t like me. So if the exploration of the question doesn’t take care of the issue, and the patient continues to ask, what’s a shrink to do? Read more »
*This blog post was originally published at Shrink Rap*
August 5th, 2011 by AnnMacDonald in Opinion, Video
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When I leave for work in the morning, I go through my precommute checklist. Train pass, check. Wallet, check. Coffee mug, check. Smart phone, check. Keys to the house, check. Only when I’m sure that I have everything I need do I open the door and head outside.
Sometimes I worry that this morning routine is becoming too much of a ritual. Is it possible that I have obsessive-compulsive disorder (OCD for short)?
Probably not. The fact that I am able to get out the door every morning means that my daily ritual isn’t interfering with my ability to function, says Dr. Jeff Szymanski, a clinical instructor in psychology at Harvard Medical School.
You have OCD when obsessions and compulsive behavior Read more »
*This blog post was originally published at Harvard Health Blog*
July 24th, 2011 by Harriet Hall, M.D. in Opinion, Research
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Antidepressant drugs have been getting a bad rap in the media. I’ll just give 3 examples:
- On the Today show, prominent medical expert
Tom Cruise told us Brooke Shields shouldn’t have taken these drugs for her postpartum depression.
- In Natural News, “Health Ranger” Mike Adams accused pharmaceutical companies and the FDA of covering up negative information about antidepressants, saying it would be considered criminal activity in any other industry.
- And an article in Newsweek said “Studies suggest that the popular drugs are no more effective than a placebo. In fact, they may be worse.”
Yet psychiatrists are convinced that antidepressants work and are still routinely prescribing them for their patients. Is it all a Big Pharma plot? Who ya gonna believe? Inquiring minds want to know:
- Are antidepressants more effective than placebo?
- Has the efficacy of antidepressants been exaggerated?
- Is psychotherapy a better treatment choice?
The science-based answers to the first two questions are Read more »
*This blog post was originally published at Science-Based Medicine*
When we talk about psychotherapy, one aspect of what we look at is the process of what occurs in the therapeutic relationship. This is an important part of psychodynamic-based psychotherapy, meaning psychotherapy that is derived from the theories put forth by Freud. Psychoanalysis (the purest form of psychodynamic psychotherapy) includes an emphasis on events that occurred during childhood, and a focus on understanding what goes on in the relationship between the therapist and the patient, including the transference and counter-transference.
