Good morning. I'm sending you to look at two articles today, both by or about people who have been on our blog before.
Over in the New York Times, Robin Weiss has a fabulous article about her work with a patient who wanted to know details of her personal life, "The 'rules' of psychotherapy." Dr. Weiss talks about how revealing such information goes against the 'rules' of psychotherapy, and she discusses reasons why she decided that in this case, it made sense to break the rules. She writes:
As therapy continued with her, I heard how flat and tinny I sounded whenever I attempted to analyze what was going on between us. When I lapsed into too clinical a mode, our connection would wobble, and her alienation became palpable.
In contrast, as I began, in the face of her challenges, to let down my guard, our alliance grew stronger, and she became open to treatment. We would laugh together about her bringing me just the right greeting card or a flower from her garden — exhibiting her need to challenge “the rules” and exposing my need to interpret her actions. These interactions helped develop her capacity to observe herself in action, as she courted me in her Sherpa style.
I may have been a slow student, but eventually I understood: I was the one who had to change. From then on, when she saw that look in my eyes, I said yes, I did have a migraine. We followed episodes of the TV show “ER” together, and I told her where I was going when I left for vacation.
I like the flexibility this articles conveys. All patients aren't alike, they (and their psyches) don't all follow, or even know, the rules. It's good to question things when the treatment doesn't seem to be working.
And in the New Yorker, Jeff Swanson, a medical sociologist at Duke, is interviewed for an article by Maria Konnikova for "Is there a link between mental health and Gun Violence?" Dr. Swanson has a wonderful idea: instead of preventing people from owning guns because they have a psychiatric diagnosis, we should prevent people from owning guns because they are violent. Konnikova writes:
In all of his work, Swanson has found one recurring factor: past violence remains the single biggest predictor of future violence. “Any history of violent behavior is a much stronger predictor of future violence than mental-health diagnosis,” he told me. If Swanson had his way, gun prohibitions wouldn’t be based on mental health, but on records of violent behavior—not just felonies, but also including minor disputes. “There are lots of people out there carrying guns around who have high levels of trait anger—the type who smash and break things,” he said. “I believe they shouldn’t have guns. That’s what’s behind the idea of restricting firearms with people with misdemeanor violent-crime convictions or temporary domestic-violence restraining orders, or even multiple D.U.I.s.”