Usable Insight – Maybe you’re just wrong
Illness vs. Hubris: What would you choose?
Recently when I have been seeing couples or families or individuals in which an Axis I psychiatric illness (major depression, anxiety, bipolar illness, schizophrenia according to the current psychiatric diagnostic nomenclature that usually requires some sort of medication) is clearly not present I have offered them the following choice.
“Either I can diagnose you as having a sickness or illness and direct you towards treatment with psychotherapy (possibly long term) and possible medication and refer you to someone else who does much more of both currently than I or…
I can view you as being factually wrong, psychologically flawed and emotionally immature and work with you to correct all of these. By this I mean you are first looking at the world through a filter that is just a filter and not necessarily accurate with regard to any situation. Next you are psychologically processing that misperception in a way to cause you to view and treat your interpretation as an absolute immutable fact. Finally when you feel disappointed, hurt or frustrated in conjunction with that belief instead of pausing momentarily to reflect and then considering your options you immediately act on those feelings in ways that nearly always makes matters worse.”
When I offer this “pick one or the other choice” to many clients, they are at first taken aback to see if I am serious. When they see that I am, they pause and seriously consider the implications of either choice and then choose the second.
At that point we work as partners moving towards the common goal of their adjusting their perception to an alternate and more positive interpretation, processing even that positive interpretation as a possibility vs. a hardened fact, and then pausing before they react.
What would you choose?
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August 4th, 2009 at 5:10 am
You cut to the quick.
Change the way people see their condition and
they change how the condition effects them.
August 4th, 2009 at 5:29 am
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August 4th, 2009 at 7:27 am
My son told me to check out your blog and I must say I’m impressed, very helpful.
August 4th, 2009 at 8:26 am
Usable insight: “Maybe you’re just wrong” impressed me greatly and will assist me with my patients, my family, and my own life as well.
Thank you Mark.
Sincerely,
Danice Akiyoshi ND
August 4th, 2009 at 10:45 am
Terrific comments again, Dr. Mark. We’re often brought in to a firm to train individuals because of a “communication problem”, and soon realize that the situation is beyond our skills as communication trainers. Then we refer the firm to Dr. Goulston, who hones in on the matter quickly, as the usable insight above clearly demonstrates.
August 5th, 2009 at 5:44 pm
Valuable thoughts and advices. I read your topic with great interest.
August 7th, 2009 at 11:07 am
In truth, immediately i didn’t understand the essence. But after re-reading all at once became clear.
August 22nd, 2009 at 4:44 pm
Let’s take a different approach. No matter what the diagnosis a patient presents, everyone comes up with certain issues. A person may not like someone, or is uncomfortable or evene embarrassed by another individual, but it may not be related to any other occurrences in the persons life. Whatever happens in the moment, may just be what it is, and can just be accepted as it is what it is.
June 8th, 2010 at 12:09 am
Great post!
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