Stability
Configuring a stable and consistent treatment
setting is analo-gous to the “holding environment” provided by parents in early
childhood (Winnicott, 1960). Patients with psychiatric illnesses will find it
very difficult to entrust their lives to a psychiatrist whom they perceive to
be unreliable. Indicated measures regard-ing stability include formulating an
agreement with the patient for a treatment regimen that will take place
according to a spe-cific method and schedule, encouraging truthful disclosure
and cooperation; establishing a commitment to beginning and ending sessions on
time, discouraging interruptions during treatment sessions; offering advance
notice as to when the psychiatrist will be absent, providing for coverage by
another practitioner when the psychiatrist is off duty, maintaining coherent
therapeutic demeanor; and maintaining relative consistency as to who
par-ticipates in the treatment situation.
It is generally unwise for a psychiatrist to
disparage a patient’s complaints about issues like the doctor’s tardiness in
starting sessions or to become defensive when explaining the meaning of the
patient’s distress about such complaints. Many psychiatrists experience
patients’ demands for consistency as a form of control and imprisonment. Out of
anger, they may react to these patients as if their wishes for reliability and
concern were infantile and irrational:
Your complaints about my lateness are a reflection
of your need to control me.
The psychiatrist’s tardiness might in fact be
creating tre-mendous anxiety because it reminds the patients of parents who
never took their feelings into account.
Related Topics
Privacy Policy, Terms and Conditions, DMCA Policy and Compliant
Copyright © 2018-2023 BrainKart.com; All Rights Reserved. Developed by Therithal info, Chennai.