August 2nd, 2011 by Dinah Miller, M.D. in Opinion
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In the Clinical Encounters case featured here two days ago, I presented the story of a psychiatrist who goes for a urological procedure and discovers that one of his former patients is the nurse assisting. People wrote in to suggest ways he should handle this awkward situation and I was struck by the idea that some suggested he tell the urologist that he knows the nurse in a social setting (because he can’t tell the other doc that the nurse was his psychiatric patient) and the assumption that the urologist would be understanding, and that perhaps the urologist should have policies in place in case of such events.
Do surgeons think this way? Read more »
*This blog post was originally published at Shrink Rap*
July 23rd, 2011 by Dinah Miller, M.D. in Book Reviews, Opinion
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Rob Dobrenski, PhD. is a psychologist who blogs over on ShrinkTalk.net. He’s written a book about what it’s like to be a psychology graduate student, a psychotherapy patient, and a psychologist. Oh, we like the folks who go from Shrink blog to Shrink book — it somehow feels familiar — and so I agreed to read his book: Crazy: Tales on and Off the Couch.
So bear with me while I tell you that the book rubbed me wrong at the outset. Dr. Dobrenski begins by saying something to the effect that he describes things that all shrinks feel, and if they say they don’t, they aren’t being honest. I really hate it when people tell me what I feel. It’s like saying that Prozac made your depression better and if it didn’t, then you just didn’t recognize it. And then the book gets off on a provocative start — Rob discovers that many people in his life, from a patient, to a colleague, to himself — are “f***ing crazy.” The asterisks are mine. Dr. Dobrenski had no trouble using the word — I counted 19 times in the 39 pages, including in direct quotes of discussions he has with both a patient and one of his supervisors. Not in a million years. I wasn’t sure what the point was. To let people know he knows obscene words? To be Read more »
*This blog post was originally published at Shrink Rap*
July 16th, 2011 by Dinah Miller, M.D. in Opinion
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Dr. Maureen Goldman talks about self-disclosure for psychiatrists and brings the topic up in the context of Marsha Linehan’s recent announcement that she was treated for a psychiatric disorder as a teenager.
In Clinical Psychiatry News, Dr. Goldman notes:
Psychiatric care and psychotherapy are different from the Alcoholics Anonymous fellowship, where the mutual sharing of personal experience is an integral part of helping people maintain sobriety. I believe that there is middle ground between disclosing personal information and presenting myself as a blank slate. In my practice, I show myself to be a real person. I make mistakes and admit them. I joke about my poor bookkeeping skills and inferior technological skills. I look things up during sessions if necessary, and I tell patients when I need to do research or consult with a colleague. I treat them as real people, too, not just as patients.
I do not, however, share my own story. Mostly, I think that I can help people feel heard, understood, and known, and create a therapeutic plan without personal disclosure. I communicate that “I get it” without being clear that “I really get it.”
I cannot speculate about the motivation behind Dr. Linehan’s decision to allow her mental health history to be chronicled in the New York Times. The story was a very public disclosure, and in that way quite different from a disclosure made in the context of a one-on-one, doctor-patient therapeutic relationship.
We’ve talked in detail about self-disclosure before, and specifically about whether psychiatrists should tell their patients if they’ve suffered from a psychiatric disorder. See Read more »
*This blog post was originally published at Shrink Rap*
July 12th, 2011 by Emergiblog in Opinion, True Stories
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Ah, the benefits of sand therapy!
Time for little Bettina’s daily afternoon face plant!
Not only does it appear my colleague is about to lose her grip on her patient, I’m concerned about her choice of body mechanics.
I predict a lumbar strain in 3…2…1……
(This photo is from the Library of Congress collection.)
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I love my pediatric patients. While it is hard to see children feeling sick, they can be bright spots in occasionally hellacious shifts.
I’ve blogged before on my observation that the kids seem to be the adults in the some families.
- They don’t want to undress for an exam, so they fight the parents who are helpless in the face of taking a shirt off a three-year-old.
- They have to be restrained so they don’t run rampant in the ER, and they slap their parent across the face. The parent doesn’t respond.
- They are told they need to cooperate with a procedure and they answer their parent with a loud, clear, “F*** YOU!” At the age of five. The parent retreats. Read more »
*This blog post was originally published at Emergiblog*
July 12th, 2011 by Toni Brayer, M.D. in Opinion, Research
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Two news events got people talking recently. One was that Casey was deemed not guilty of killing little daughter Caylee ( “O.J. all over again”, I heard repeatedly). I must admit I was rather surprised….
The second was the results of two new studies that were published in the Archives of General Psychiatry. One of them stated that environmental factors during pregnancy might contribute as much as genetics in the development of autism spectrum disorders. The 2nd study conducted by Kaiser Permanente Northern California found a 3 times higher risk of autism if the mother took antidepressants in the first trimester of pregnancy.
With the incidence of autism disorders increasing over time to the current range of 3-6 per 1,000 births, these studies are of interest to millions of parents and professionals. Autism affects boys at a rate of three times more than girls, and is usually detected by the age of 3. The cause has been maddeningly unknown.
While genes certainly play a part (as they do in most every disorder) other theories and assertions have been disproven. It certainly does not have anything to do with “poor mothering” or “lack of maternal bonding”. Those theories did more harm than bloodletting in the 19th century! The link between autism and vaccines has been thoroughly debunked. If you believe in science and research, you must believe that vaccines are not the cause and finally leave that one in the dust. Read more »
*This blog post was originally published at EverythingHealth*
