In the mid-1980s, I was presenting a workshop at the meeting of the AADPRT that focused on the integration of psychotherapeutic and psychopharmacologic treatment. As an illustration of this education issue, I presented a young woman patient who had problems with both severe manic-depressive illness and borderline personality disorder. After I presented a videotaped treatment hour, a training director in the audience said, "I don't know why you showed this videotape. This woman has manic-depressive illness and needs medication, and that's that." Too many clinicians, and even apparently at that time some residency directors, believed that good psychopharmacology practice required only knowledge of dosages, side effects, pharmacokinetics, and indications for the medication. To me, though, the essence of good psychopharmacologic management is how I respond when a patient comes into my office and says, "Dr. Tasman, I'm not going to take that medication you prescribed." Dealing with issues of resistance and treatment compliance, even in a busy medication clinic, an emergency room, or an inpatient unit, requires psychotherapeutic skill and knowledgean ability to understand the origins and meaning of the patient's hesitancy and to use the therapeutic relationship with the patient as the force to maintain a treatment
Lost in the DSM-IV Checklist : Empathy, Meaning, and the Doctor-Patient Relationship
Abstract
In the mid-1980s, I was presenting a workshop at the meeting of the AADPRT that focused on the integration of psychotherapeutic and psychopharmacologic treatment. As an illustration of this education issue, I presented a young woman patient who had problems with both severe manic-depressive illness and borderline personality disorder. After I presented a videotaped treatment hour, a training director in the audience said, "I don't know why you showed this videotape. This woman has manic-depressive illness and needs medication, and that's that." Too many clinicians, and even apparently at that time some residency directors, believed that good psychopharmacology practice required only knowledge of dosages, side effects, pharmacokinetics, and indications for the medication. To me, though, the essence of good psychopharmacologic management is how I respond when a patient comes into my office and says, "Dr. Tasman, I'm not going to take that medication you prescribed." Dealing with issues of resistance and treatment compliance, even in a busy medication clinic, an emergency room, or an inpatient unit, requires psychotherapeutic skill and knowledgean ability to understand the origins and meaning of the patient's hesitancy and to use the therapeutic relationship with the patient as the force to maintain a treatment
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Lost in the DSM-IV Checklist : Empathy, Meaning, and the Doctor-Patient Relationship
Tasman, Allan
Follow Academic Psychiatry
, Volume 26 (1): 38
American Psychiatric Publishing, Inc (Journal) – Mar 1, 2002
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