December 24th, 2011 by Dinah Miller, M.D. in Opinion
No Comments »
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
No Comments »
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*
July 23rd, 2011 by Dinah Miller, M.D. in Book Reviews, Opinion
No Comments »
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*
June 2nd, 2011 by Dinah Miller, M.D. in Opinion
No Comments »
Here at Shrink Rap, we often talk about the stigma of having a psychiatric disorder. It’s funny, but society has it almost ranked, so that certain illnesses are very stigmatized–schizophrenia and schizoaffective disorder, and borderline personality disorder, to name a few, and others are pretty much socially acceptable: Attention Deficit Disorder, for example, especially among the high school/college crowd where the patient often gets identified (or self-identifies) as the source for those late-night stimulants that so many kids cop.
It’s not just the patients. Psychiatrists are also stigmatized, and that doesn’t help much when our society talks about the shrink shortage.
Exalya writes:
I’m a first (almost second) year medical student with a strong passion for psychiatry. I love listening to your podcasts; you give me hope for my future when the drudgery of first year classes is getting me down, and I feel like I always learn something useful.
That aside, I am writing to you seeking some advice. Read more »
*This blog post was originally published at Shrink Rap*
March 14th, 2011 by Dinah Miller, M.D. in Better Health Network, Opinion
No Comments »
Gardiner Harris had a [recent] article in the New York Times called “Talk Doesn’t Pay So Psychiatrists Turn to Drug Therapy.” The article is a twist on an old Shrink Rap topic, “Why your Shrink Doesn’t Take Your Insurance.” Only in this article the shrink does take your insurance, he just doesn’t talk to you.
With his life and second marriage falling apart, a man said he needed help. But the psychiatrist, Dr. Donald Levin, stopped him and said: “Hold it. I’m not your therapist. I could adjust your medications, but I don’t think that’s appropriate.”
Dr. Levin sees 40 patients a day. And he’ss 68 years old. This guy is amazing. There’s no way I could see 40 patients a day for even one day. He’s worried about his retirement, but I wouldn’t make it to retirement at that pace. (Should we make a bet on whether Dr. Levin has a blog?)
The article has a whimsical, oh-but-for-the-good-old-days tone. In-and-out psychiatry based on prescribing medications for psychiatric disorders is bad, but the article doesn’t say why. In the vignettes, the patients get better and they like the psychiatrist. Maybe medications work and psychotherapy was overemphasized in the days of old? The patients don’t complain of being short-changed, and if Dr. Levin can get 40 patients a day better for — your guess is as good as mine, but let’s say — $60 a pop, and they only have to come every one to three months, and there’s a shortage of psychiatrists, then what’s the problem? Why in the world would anyone pay to have regular psychotherapy sessions? Read more »
*This blog post was originally published at Shrink Rap*
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.
