Good physicians take a clinical history in the interest of arriving at a diagnosis. While the clinical history is a review of ‘facts’, there are in fact, few ‘facts’ about human experience. Different examiners will get different histories depending upon what they ask about. Different family members give different reports of the same set of events. In my view clinical histories are a form of fiction pretending to be ‘objective’.
The idea of being “ruthless” sounds jarring at first, until we realize how it’s an essential ingredient in healthy living, both personally and professionally. It speaks to how we maintain our integrity in the face of demands for conformity.
Therapists tend to be good at being kind and patient with difficult people and they know how to put up with their patients’ demanding and outrageous behavior. Too often the demand for good manners persuades therapists to compromise their integrity in the attempt to maintain the relationship and to make their patients feel worthwhile. But compromising integrity interferes with the effectiveness of therapeutic work.
Here’s an inside look at what makes marriage both incredibly challenging, and, potentially, the most enriching experience of a lifetime.
Dave offers his reflections about what it’s like to be a psychiatrist disguised as a family therapist. Hint: The language is different, and no medications required
Teenage “cutting”: Teenagers are often seen in individual therapy for the self-mutilating behavior called “cutting.” Here’s a family therapy approach that stopped the cutting by revealing what was behind her apparent self-destructive behavior.
The modern Child Psychiatry perspective is limited to focusing on the child, without including the family culture in which that child lives. This narrow understanding contributes to the child’s isolation. That little person is usually worried about, and trying to help, the parents. No matter how it appears.
Fighting is part of both healthy and unhealthy relationships. But unhealthy fighting looks different Here are two types of couples with unhealthy fighting patterns: The Disconnect and The Immovable Object.
Couples in therapy are often like the Three Bears: The temperature in the relationship is either too hot, too cold–usually not “just right”. Here’s how a couple re-set their Passion Meter.
Kids instinctively “worry”, that is, feel responsible for their families. Don’t forget that. Children worry about their families. They are trying to help the parents become not only better parents but better people. But their therapeutic methods get diagnosed as mental illness.
For Amy and Dave, common psychiatric “disorders” are part of relational patterns, usually embedded in the dynamics of the family. You just have to know how to look.
This Family Medicine hospital consultation involved a mute patient who had just had her leg amputated. The hospital staff was angry at her. Then this young doctor took the time to learn what was going on and everything changed.
When family dysfunction meets disease: How a therapy session transformed family patterns and helped a young woman improve her self-care.
Understanding and changing family relationship patterns can make a huge difference for kids diagnosed with ADHD.
Part of the appeal of the “chemical imbalance” metaphor is that it people don’t have to feel ‘guilty” about their depression, or problems with their kids. But it can keep both patients and therapists from getting to the all-important bottom of things.
The logic of “chemical imbalance” persuades both patients and practitioners that context and subjective experience are not important. But that logic interferes with the understanding the person’s pain, and what it’s made of.