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A Psychologist's Thoughts on Clinical Practice, Behavior, and Life

How To Insure That An Adult's Psychotherapy Will Fail

In addition to the therapist lacking talent and training, certain professional practices will insure that a patient's treatment fails. (1) Using a vague unintelligible diagnosis will make the patient be considered untreatable. One like "Borderline Personality Characteristics reflective of Post-Autistic Development" would be excellent. To insure confusion and professional acceptance, a biologic or genetic phrase can be added like "A possible malformation of the patient's adrenal medulla causing irregular production of the epinephrine and norepinephrine hormones may influence the patient's moods." (2) Advising that psychological deterioration is inevitable unless many years of twice-weekly individual treatment is obtained since this is rarely possible. (3) Having the most disturbed patient be treated by the clinic's least experienced worker. A beginner trainee would be a wise choice. (4) Making life decisions for the patient. This will further lower their self-esteem by indicating how inadequate their doctor believes them to be. (5) Never responding directly to a patient's question. Thus if asked why their symptom exists the doctor should reply, with an air of condescension and omniscience, "Severe problems like yours take a long time to understand." This, even if the symptom has been long understood since psychotherapy is least likely to fail when a patient receives explanation.

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