therapeutic alliance

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I remember a supervisor from the past whom I never thought had the right personality to be a psychiatrist.  I mean, he was a little angry and domineering for my taste.  But heck — I gave him a “bye” since he worked in a prison context.

I was never attacked by a prison patient through my tours-of-duty through four (all-male) California state penal institutions.  I had a couple who ended up on their knees, crying, stroking my hands, or even asking permission to kiss me (denied, of course).

They said I was “nice” to them.  I guess I treated them like human beings — something pitifully lacking in the prison system where everything seems oppressive and depersonalizing. Read more on Assaults On Psychiatrists…

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“Concordance.”  That means doctor and patient wanting the same thing.  In psychiatry we call it a “therapeutic alliance.”  We work for it — assuming we have the time.  But if the time is not there, on some level we all know that nothing will happen.

Leave it to the pharmacists to at least touch on a reason for “lack of concordance” that nobody seems to discuss. “With increasing numbers of medications shown to do more good than harm when taken as prescribed, low compliance is a major problem in health care,” reads an unpretentious sentence in the abstract.

And people wonder why there is no “trust” between patient and doctor. Read more on Trusting Your Doctor…

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