tag:blogger.com,1999:blog-26666124.post3365239551735489506..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: Is it Ever Okay to Lie?Unknownnoreply@blogger.comBlogger44125tag:blogger.com,1999:blog-26666124.post-26755381253503711572011-11-25T19:19:58.703-05:002011-11-25T19:19:58.703-05:00Providers of any care must assume that they will f...Providers of any care must assume that they will face dilemmas where their own personal experiences or relationships will be invariably unjustly investigated by a patient or another person in their lives. <br />One must possess the skills of reorganizing a situation so that it is positive both to yourself and the person who is pursuing a realm of your relationship that is off limits. <br />It is not ethical or proper to lie on a form of employment or other inquiry of personal data as suggested by the patient. We are all in situations we may not enjoy and there are always realizations that a lifestyle or other experience we may wish to pursue may not be to our success as we may have a true limitation or a legal situation that does not fit with the choices of the reviewing authorities for which we are applying or situating our own interests. <br />If there is a legal reason why some information is not to be shared, such as a health condition to a new employer per se, that is to be explored with your physician and or legal help if necessary. <br />In the case you cited where the patient wants to know if you liked him or not, a more intelligent reply for a professional is to comment on the positive qualities of the patient and indicate whether or not you are able to continue to provide the care or services that the patient necessitates. <br />No health provider or other professional for that part can be preferential in a integration of his or her own feelings towards one patient or another. To do so, in my beliefs is essentially unprofessional and thus crosses the line to a situation where you are simply playing to favorites and not ethically practicing your profession.C.J. Brennerhttps://www.blogger.com/profile/00564328005764077809noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-35086082540781900582011-11-12T19:07:23.482-05:002011-11-12T19:07:23.482-05:00I'm a teacher, and if a kid ever asked me if I...I'm a teacher, and if a kid ever asked me if I liked him, or if I was bored reading his paper, it's not likely that I'd say I didn't like him at all and was bored silly by his paper. <br /><br />I'd likely try to tactfully encourage him to use x, y, z, strategies to strengthen his paper...but I'd certainly never say, I don't like you, even if he was the most disagreeable child I've ever met. There's something to be said for a therapeutic alliance, whether in therapy or not. Or perhaps it's more the old adage - you catch more honey with flies then with vinegar.....Jennoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-69253229889862149042011-11-10T17:33:50.048-05:002011-11-10T17:33:50.048-05:00Thanks Sunny!Thanks Sunny!Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-33375628069540786802011-11-09T22:32:21.461-05:002011-11-09T22:32:21.461-05:00@A Girl, yes, as you note, the second example is v...@A Girl, yes, as you note, the second example is very tricky, and my point in using it was to show that simply answering a question can be a landmine. There are many other such examples, though not as dramatic. Very often I find that just as in mathematics one can test an hypothesis by taking it to the limit. I think it is important to try to look beneath any rule or example to find the underlying principle. <br /><br />Being boring (or being bored) is not a quality, like having red hair, that is objective. I can imagine a doctor who repeatedly does the same procedure over and over getting bored with his work, but in dynamic or analytic psychotherapy we never encounter exactly the same situation twice. If we are bored there is almost always some problem that we need to confront.<br /><br />The psychiatrists I know truly like people. There are many fields in which one can excel without liking people, but psychotherapy is not one of them.jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-39560117974814123292011-11-09T19:29:03.552-05:002011-11-09T19:29:03.552-05:00@ Jesse - yup, you got it right the second time. :...@ Jesse - yup, you got it right the second time. :)Anoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-57805797565431650902011-11-09T17:29:33.717-05:002011-11-09T17:29:33.717-05:00@Jesse:
Thank you for your well thought out repl...@Jesse: <br /><br />Thank you for your well thought out reply. I do agree with you, and I think that perhaps we are working from two similar but not identical angels.<br /><br />I agree with you that just thoughtlessly blurting out the truth may not be the best course of action. <br /><br />F.ex. in your first example, the therapist might answer quite truthfully that the patient was not boring him. This would risk invalidating the patients observation ("Your attention is elsewhere") without offering an explanation. Or the therapist can turn the question around - Why do you ask? - thereby putting the patient on the defensive ("I don't know, it's just a hunch, and now that you ask, I don't have the words to tell you, I'm just going to crawl back into myself and talk about something else"). Either way, the results could potentially destroy the therapeutic relationship, and the therapist might never figure out why. After all, the whole interaction seemed utterly harmless to him/her.<br /><br />So yes, here I'd maintain that the best answer would be to tell the whole truth, namely that they were distracted. Who knows, a patient with low self-esteem might even get a huge kick out of playing a therapist to the therapist :)<br /><br />Your other scenario is much worse - "Do you find me attractive?" That question can potentially be used to manipulate, and even if it is asked in all innocence, it's still hard to find a good answer. <br /><br />On the other hand - my mum used to ask me that, a hundred times every time we met. In the end, I got so fed up, that I told her the truth: she is well past her seventies, has led a hard life, been a heavy smoker all her life, and has not had the money for relaxing spas and plastic surgery. Attractive just isn't in the ballpark anymore. From now on, she needed to work with phrases like dignified, and gracious. It was rather rude of me, but surprizingly, she gave me a happy smile, and stopped asking (quite so much anyway).<br /><br />I'm not religious in any way, but I do believe that the truth can set you free - as long as it is used wisely.A Girlnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-74642452080329856752011-11-09T15:13:38.976-05:002011-11-09T15:13:38.976-05:00"...this fear of seeming narcissistic or self..."...this fear of seeming narcissistic or self-centered is common, and a great topic for it's own post."<br /><br />I'd enjoy reading about this, Dinah. And I meant to type Yalom not Yolam in my previous comment.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-7943538547744673282011-11-09T14:35:08.513-05:002011-11-09T14:35:08.513-05:00@A Girl: A patient says to a psychiatrist “do you ...@A Girl: A patient says to a psychiatrist “do you find me boring?” What is the overall context? Perhaps the psychiatrist has been distracted by some personal concern, and the patient frames his observation of that by asking if in fact he, the patient, were boring to the doctor. It could be that the patient has frequently thought he was boring to others. Perhaps a woman patient had been talking about a problem at work, speaking in a monotone, but by doing that she was avoiding talking about her conflicted feelings about a sexual matter.<br /><br />There are near infinite possibilities. If the therapist “answers the question” without having thought about the context, history, diagnosis, etc. he may be steering the question away from the important underlying problem and into a safe surface issue. <br /><br />Yes, there are times when one does answer a question simply and directly, then looks at the underlying issues. Therapy is hard work, requiring one to think and feel on several levels at once. Just as in the best of modern design, the simplest answer may cloak the most sophisticated analysis.<br /><br />To frame this another way, imagine a woman patient asking a male therapist “do you think I am attractive?” That question contains so much! Would you think it should be directly answered, rather than that the therapist should consider what generated it and the ramifications of the answer?jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-84685873394230221162011-11-09T10:30:41.218-05:002011-11-09T10:30:41.218-05:00"Choose to act , then deal with the conseque..."Choose to act , then deal with the consequences."<br /><br />So if a person is comfortable with the consequences (jail) they should choose to commit murder? The other limitation inherent in this is that it is not always the case that the actor has to deal with the consequences. Consider suicide. That is an act, the consequences of which are not dealt with by the person who chooses it.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-40362626446103419772011-11-09T10:10:57.827-05:002011-11-09T10:10:57.827-05:00I love Dinah’s approach to responding to inappropr...I love Dinah’s approach to responding to inappropriate questions. See also Penelope Trunk on lying in response to questions it’s illegal to ask: http://blog.penelopetrunk.com/2009/05/11/three-times-you-should-lie-at-work/<br /><br />Another way to think about Carrie’s musing on conflicting duties is Sartre’s existentialism: choose to act, then deal with the consequences. The example he gives is also from World War II: a student, now an only child, who must choose between joining the Resistance to avenge his brother killed in the German offensive of 1940, or staying with his mother at home. Neither choice can be justified through any system of reasoning because they each cause a wrong of similar weight. The student just has to choose, that’s all. So choose, and live with the choice. <br /><br />http://www.associatedcontent.com/article/152642/should_one_go_to_war_or_not_a_study.htmlAlison Cumminshttps://www.blogger.com/profile/06370841996857073237noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-32840752605581034282011-11-09T08:57:10.242-05:002011-11-09T08:57:10.242-05:00I think that with the Gestapo question we have an ...I think that with the Gestapo question we have an answer: Yes, there are times it's not only okay to lie, but it's wrong not to.<br /><br />Maybe it's misguided that it's been so hammered in to us that it's wrong to lie, and yet we are never taught that it's wrong, or unethical, to ask intrusive questions. Of course you can say "That's none of your business" (which is considered rude), or "I don't wish to answer that" but then there is the assumption that the answer is "yes," because why wouldn't someone simply say 'no' to a question like, "Have you sexually abused your cat?" If we anything, we hear messages like, "there's no stupid questions..." <br /><br />While patients don't generally ask if they are boring, this fear of seeming narcissistic or self-centered is common, and a great topic for it's own post.<br /><br />I think some of our commenters are not happy with the idea that a psychiatrist might be bored. Ah, if only we were people who had been ordered a from a catalogue. I'm also not aware that 'self-awareness' is in the job description to treat psychiatric disorders, except for psychoanalysts who must undergo analysis first and I've never been impressed that this process turns them in to better people. <br /><br />I do think there is some therapeutic value to answering these questions (especially if the answer is honestly "you're not boring at all"). There sometimes feels like once there's been some exploration, that to leave the question unanswered and leave the patient uncomfortable and wondering, also loses the opportunity to correct negative assumptions the patient makes and the "why do you always see yourself in a negative light" issue.<br /><br />Maybe I will be as wise as Jesse when I'm less impulsive.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-6512097352104157802011-11-09T08:26:33.389-05:002011-11-09T08:26:33.389-05:00It's a matter of duties - when most people bel...It's a matter of duties - when most people believe that lying is wrong, but there are some times that you WOULD lie - then what are you upholding that is so powerful you'd allow it to trump a lie?<br /><br />In the Nazi example, protecting life is a higher duty than being honest. It still doesn't make lying "right", but when duties conflict, one is going to trump the other one at some level.<br /><br />wv = hurthe; lying hurtheCarrienoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-37311771131690882952011-11-09T04:55:41.804-05:002011-11-09T04:55:41.804-05:00Sometimes I bore myself when I see my psychiatrist...Sometimes I bore myself when I see my psychiatrist. I know he is bored and cannot think of anything to say. If I asked him if he was bored he would deny it vehemently, even though it was obvious he was struggling. So I would never ask him.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-69872131025707009262011-11-09T04:00:47.357-05:002011-11-09T04:00:47.357-05:00@Jesse
I'm not sure that I follow your answer...@Jesse<br /><br />I'm not sure that I follow your answer. The question originally posed implies that the patient is boring - otherwise there wouldn't be an ethical dilemma involved. <br /><br />The overall context of the question might be a fine thing to explore, but I'd easily get the impression that the true answer was being avoided. I agree that the framework needs to be worked with, but I think it is equally important, if not more so, to answer the question truthfully, and work from there.<br /><br />For the record, I've never worried if I bored my therapists. But I know that I've antagonized and frustrated them, sometimes on purpose, and I've seen them be unwilling to admit to these feelings. <br /><br />(Granted, it's hard to answer truthfully about things you don't realize yourself. But isn't a certain form of self-awareness was implied in the job-description?)<br /><br />@Rob : I have never lied to my now husband in that regard. It took us some years to figure out what worked, and I can't guarantee that his self-esteem didn't get bruised in the process, but in the end we had a great sex-life. So great, in fact, that we got kid, and now we have to start all over again :) <br /><br />And from my observations (n=1), I find that it is true that men can have differing organisms, just like women.A Girlnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-80862166644662691052011-11-08T23:37:38.714-05:002011-11-08T23:37:38.714-05:00Sarebear: I am another person who never finds you ...Sarebear: I am another person who never finds you boring.<br /><br />I remember being concerned at one point because I felt like a "broken record" in therapy sessions in that what I said seemed to be similar to what I had said the week before and the week before that. I think I was getting bored with myself or at least impatient with my slowness to change. I told my psychiatrist at that time, that I seemed to be slow at making "progress" and perhaps his time would be better spent with someone else who I imagined might make more rapid progress. My psychiatrist laughed and asked me in turn something like, who do you think I ought to replace you with, Michelle Pfeiffer? I really thought at that point, that there might be someone more "worthy" of my psychiatrist's time than I was. I think the question was a reflection of my feelings of inadequate self-worth. I think it would have reinforced my feelings of inadequacy if my psychiatrist had said "You really are a broken record and I think you are right that you are wasting my time when there are lots of more worthy patients waiting for my services." I don't think he had to lie to answer my question as he did and the effect was that he did make me feel "wanted" as a patient.Sunny CAhttps://www.blogger.com/profile/11451116932556227816noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-2280972346866246682011-11-08T22:44:28.138-05:002011-11-08T22:44:28.138-05:00Anon #3, who wrote about Yolam, got it right. Hon...Anon #3, who wrote about Yolam, got it right. Honesty certainly may not be therapeutic, but I also think a lot of patients sense when the truth is being side-stepped, softened or reframed. Personally, I stopped worrying about whether my therapist thinks I'm boring years ago because, well, I can be boring. That said, the first psychiatrist I worked with once told me he didn't want to be patronizing or insincere when I asked him why he rarely pointed out any of my strengths when I was so hard on myself. Seriously, one of the few nice things he ever said was "at least you're not fat". It didn't sound much better in context either, but at least I can laugh about it now.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-58254121866927503152011-11-08T22:17:00.353-05:002011-11-08T22:17:00.353-05:00Jesse,
German Jews were stripped of most of their...Jesse,<br /><br />German Jews were stripped of most of their rights by 1939 ,but mass deportation of Jews from Germany did not begin until post 1939.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-41078466449379332352011-11-08T20:34:56.841-05:002011-11-08T20:34:56.841-05:00Rereading, I definitely misunderstood A. Sorry, A,...Rereading, I definitely misunderstood A. Sorry, A, apologies are warranted.jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-9010528656228988112011-11-08T20:26:34.980-05:002011-11-08T20:26:34.980-05:00Perhaps I misunderstood A. He might have been maki...Perhaps I misunderstood A. He might have been making the same point I just did.jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-6296840363695182082011-11-08T20:25:27.647-05:002011-11-08T20:25:27.647-05:00I can't resist answering A above: so you are i...I can't resist answering A above: so you are in 1939, in Germany, and the Gestapo knocks on the door and asks if there are any Jews in the house. Yes, in fact you are hiding one in the attic. Your answer, A?<br /><br />This is the problem with absolutes. One needs to extrapolate to the extremes to get at underlying principles.jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-365300578880621582011-11-08T19:41:44.029-05:002011-11-08T19:41:44.029-05:00I know what you're trying to get at, obviously...I know what you're trying to get at, obviously, but....Is it EVER okay to lie? Really? Is it EVER okay to hit? Well, what about in self-defense? Is it EVER okay to steal? What if you're starving...the list goes on indefinitely. <br /><br />Let's not pretend therapists stick to a black and white definition of ethics! (Though god, it would be nice if they did....)Anoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-37799919185318003602011-11-08T16:53:07.075-05:002011-11-08T16:53:07.075-05:00Rob's definition: wv = subrosms; climaxes that...Rob's definition: wv = subrosms; climaxes that don't exactly put the lights out. Ladies, I think you know what I mean.<br /><br />Men know what that means too! Plenty of men fake sexual pleasure. I read that on Yahoo years ago. Though I noticed there were only two reasons the men gave: marathon sex throughout the night, and they were really tired of sex (but not the idea of having sex). Or they were injured in some way but felt like they still needed to perform and so it wasn't that good.Janehttps://www.blogger.com/profile/06030949818467743750noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-83011070247226294182011-11-08T16:46:04.941-05:002011-11-08T16:46:04.941-05:00"I wonder if treating professionals get the i..."I wonder if treating professionals get the idea that their patients are all narcissists, when in fact, they are at the appointment in order to get help, and uncharacteristically talking about themselves?"<br /><br />I have wondered this very same thing myself, CatLover. I have met one where I was absolutely convinced he thought I was a narcissist (I only saw him once). <br /><br />You know...if a shrink is getting bored, he or she ought to wonder why. I would really hope the shrink would be problem solving and using full mental capacities throughout the appointment. Shrink's are expensive and patients wanna get their moneys worth. Especially for a med management purist who doesn't even spend more than 20 minutes with a patient. If a shrink is bored, this may be a sign that the way therapy is being conducted should be reevaluated.Janehttps://www.blogger.com/profile/06030949818467743750noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-85049132933236773082011-11-08T13:21:43.067-05:002011-11-08T13:21:43.067-05:00Patients are not seeking help to entertain psychia...Patients are not seeking help to entertain psychiatrists. <br />That would be weird.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-61548436591709691812011-11-08T13:12:28.198-05:002011-11-08T13:12:28.198-05:00Off topic, but I noticed someone said they felt na...Off topic, but I noticed someone said they felt narcissistic talking about their problems in sessions. I feel like that too and I RARELY talk about my problems with anyone other than my spouse in everyday life. I wonder if treating professionals get the idea that their patients are all narcissists, when in fact, they are at the appointment in order to get help, and uncharacteristically talking about themselves?CatLovernoreply@blogger.com