November 26th, 2011 by Dinah Miller, M.D. in Opinion
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I’ve been asked several ‘ethical dilemmas’ in the past few weeks. I’m putting them up on Shrink Rap, but please don’t get hung up on the details. These aren’t my patients, but the details of the stories are being distorted to disguise those involved. The question, in both cases, boils down to: Should the mental health professional report the patient to his professional board?
In the first case, a psychiatrist is treating a nurse who is behaving badly. The nurse is stealing controlled substances from the hospital and giving them to friends who ‘need’ them. She doesn’t intend to stop, and her contact with the psychiatrist was only for an appointment or two before she ended treatment. Should the psychiatrist contact the state’s nursing board? Is he even allowed to?
In the second case, 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*
November 7th, 2011 by AnneHansonMD in Opinion
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Regular readers know that every year I tweet and blog from the conference of the American Academy of Psychiatry and Law. This group of forensic psychiatrists consists of about 1800 of the country’s practitioners. Topics are quite diverse and sometimes rather unusual. It’s a lot of fun. Here’s just a small smattering of factoids I picked up last week:
- The “sovereign citizen” defense can prompt a competency eval, but is not a delusion. The sovereign citizen movement is a recognized subculture of people who believe the government has no jurisdiction over them.
- Of 200 defendants cleared by DNA, one-fourth had confessed to the crime.
- According to FBI uniform crime reports, Read more »
*This blog post was originally published at Shrink Rap*
October 26th, 2011 by PeterWehrwein in Research
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Remember when the best-selling book Listening to Prozac came out almost 20 years ago?
Now Americans aren’t just reading about Prozac. They are taking it and other antidepressants (Celexa, Effexor, Paxil, Zoloft, to name just a few) in astounding numbers.
According to a report released yesterday by the National Center for Health Statistics (NCHS), the rate of antidepressant use in this country among teens and adults (people ages 12 and older) increased by almost 400% between 1988–1994 and 2005–2008.
The federal government’s health statisticians figure that Read more »
*This blog post was originally published at Harvard Health Blog*
I’ve been asked several ‘ethical dilemmas’ in the past few weeks. I’m putting them up on Shrink Rap, but please don’t get hung up on the details. These aren’t my patients, but the details of the stories are being distorted to disguise those involved. The question, in both cases, boils down to: Should the mental health professional report the patient to his professional board?
