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Monday, September 06, 2010

The Repost on James J. Lee and Schizophrenia

For those of you who never saw the post below, I brushed it up.  Please let me know if you're still not receiving the emails from Feedburner, btw.

7 comments:

Anonymous said...
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Anonymous said...
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Anonymous said...

I'm wondering if you've done any posts on professional boundaries...I often look to your blog for ideas on "How would TD do this??"

I have a dilemma with a psychiatrist. I spent much time with him during my internship, and he taught me many things, both that I found useful, and how I thought we ought NOT do things' He's the only show in town in regards to inpatient. He's highly competent in some areas; I've seen him get many people much, much better that had been treatment resistent for ages...Anyway, I have a borderline, sexually abused client that is also his. He has very blurry boundaries with her. Hires her to do some extra things. His wife shares details about their marriage with her. I have big big issues with this, and have told the client that although he means well, it's not helping her to set appropriate, healthy boundaries...She, of course, idolizes this man of power, who in her eyes, has saved her life...Sigh....suggestions?

therapydoc said...

Terrible situation, packed with potential problems. If you can punt to another doc, you should, and you're friend will learn the hard way.

therapydoc said...

Dear Anon 2,
That was impulsive, I guess. The truth is that you do share responsibility for this person, the patient. You have signed on to help her and you can't just punt, didn't mean to sound insensitive. You probably do need to work with the doc, find out what's going on in his head. There are docs who do milieu therapy, and this could be what's going on. In any case, the doc's wife needs a lesson on boundaries and the three of you need to work together. Of course, you better get a release to talk to his spouse. But that sounds easy enough!

therapydoc said...

Dear Anon 2,
That was impulsive, I guess. The truth is that you do share responsibility for this person, the patient. You have signed on to help her and you can't just punt, didn't mean to sound insensitive. You probably do need to work with the doc, find out what's going on in his head. There are docs who do milieu therapy, and this could be what's going on. In any case, the doc's wife needs a lesson on boundaries and the three of you need to work together. Of course, you better get a release to talk to his spouse. But that sounds easy enough!

Anonymous said...

Thanks for your input. What I HAVEN'T done is talk to the doc. What I HAVE done is talk with my patient about how we are human and don't always set good boundaries ourselves and that I am concerned about the doc's bringng her into his personallife. I have offered to refer her to another psychiatrist. Of course, she won't have it. And I guess I'm okay if she would mention to him what I have shared with her. He's a bit of a narcissist. Thinks that HE can handle those blurry boundaries, while the rest of us can't... My own colleagues rarely refer to him because of this tendency of his. I only do if I have to, or if they have already been to him and then refer to me. I suppose I could refuse to see his people...(small town, etc...)He was one of my mentors, so I have my own issues with "questioning his authority." He's lucky he hasn't been turned in. He has his WIFE hire her, but I still don't think the board would find that acceptable.