tag:blogger.com,1999:blog-26666124.post6362804376666488288..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: Guest Blogger Louis Breger on Psychotherapy-- More of the Good & BadUnknownnoreply@blogger.comBlogger6125tag:blogger.com,1999:blog-26666124.post-91027642586267116842012-07-19T12:12:10.895-04:002012-07-19T12:12:10.895-04:00I'm posting this for Dr. Breger:
The issue of...I'm posting this for Dr. Breger:<br /><br />The issue of diagnosis and the DSM is a bit complex. Clearly, those of us who have been around the field a long time use various labels as a shorthand way of communicating, as when we say that person is a "borderline" or is on the "aspergers continuum. But, my overall stance, which I feel very strongly about, is that every person is unique and, as a therapist, it is crucial that I understand them in their own terms. If I have their DSM diagnosis at the forefront of my mind, it interferes with such attention and understanding. Obviously there are certain conditions -- severe depression, bi-polar, etc. -- where one must recognize the condition so that appropriate medication can be provided. But, for the large number of my patients, this has not been the case. If I had worked with a different population this might not have been true though, if you have the patience and skill, one can work with very disturbed people, even psychotics, effectively (see George Atwood's new book, "The Abyss of Madness" for examples.). See the case of "Nate" in my new book for someone who was treated very effectively despite the fact that he would have been easy to dismiss as a schizoid character if not a schizophrenic.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-70828205002805860602012-07-13T00:53:58.399-04:002012-07-13T00:53:58.399-04:00I prefer diagnostic labels and being treated like ...I prefer diagnostic labels and being treated like an intelligent adult.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-1031127536899282482012-07-12T17:59:58.508-04:002012-07-12T17:59:58.508-04:00Oh, laying on of disagnostic labels is sometimes a...Oh, laying on of disagnostic labels is sometimes appropriate if the pt asks for it.That is the rarew thing the pt may ask for.Ask for Xanax, get refered to why docs don't like it. Ask for anything at all other than a tissue or few dxs and be prepared for a fight.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-76930386970126484142012-07-12T15:48:50.979-04:002012-07-12T15:48:50.979-04:00I am wondering about your issue of "laying on...I am wondering about your issue of "laying on diagnostic labels (though sometimes appropriate if the patient asks for it)." Do you take insurance? In that instance, how do you handle a situation where you will not get reimbursed unless you give a diagnosis? How do you deal with the patient in that instance? I mean to say, do you whip out a DSM, list symptoms, and ask the patient to go over it with you so that he or she can be given a diagnosis? Do you ask your own set of questions and form a diagnosis that way? <br /><br />I'm actually really curious. I want to compare how different therapists diagnose and how much the patient is usually involved in the final decision by the therapist.Janehttps://www.blogger.com/profile/06030949818467743750noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-55152622468583590062012-07-12T13:12:14.055-04:002012-07-12T13:12:14.055-04:00Thanks for your post. I enjoyed reading it.Thanks for your post. I enjoyed reading it.Sunny CAhttps://www.blogger.com/profile/11451116932556227816noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-19261747007424975772012-07-12T08:09:18.634-04:002012-07-12T08:09:18.634-04:00No wine, but I have a truly lovely BourbonNo wine, but I have a truly lovely Bourbonrob lindemanhttp://natickpediatrics.netnoreply@blogger.com