Good physicians take a clinical history in the interest of arriving at a diagnosis. While the clinical history is a review of ‘facts’, there are in fact, few ‘facts’ about human experience. Different examiners will get different histories depending upon what they ask about. Different family members give different reports of the same set of events. In my view clinical histories are a form of fiction pretending to be ‘objective’.
Teenage “cutting”: Teenagers are often seen in individual therapy for the self-mutilating behavior called “cutting.” Here’s a family therapy approach that stopped the cutting by revealing what was behind her apparent self-destructive behavior.
The modern Child Psychiatry perspective is limited to focusing on the child, without including the family culture in which that child lives. This narrow understanding contributes to the child’s isolation. That little person is usually worried about, and trying to help, the parents. No matter how it appears.
To be a parent is to know worry. There’s no escaping it, and there’s really no cure for it. As my blogging buddy David Keith says, “If you can’t stand guilt don’t become a parent.”
Kids instinctively “worry”, that is, feel responsible for their families. Don’t forget that. Children worry about their families. They are trying to help the parents become not only better parents but better people. But their therapeutic methods get diagnosed as mental illness.
For Amy and Dave, common psychiatric “disorders” are part of relational patterns, usually embedded in the dynamics of the family. You just have to know how to look.
When family dysfunction meets disease: How a therapy session transformed family patterns and helped a young woman improve her self-care.
Understanding and changing family relationship patterns can make a huge difference for kids diagnosed with ADHD.
Part of the appeal of the “chemical imbalance” metaphor is that it people don’t have to feel ‘guilty” about their depression, or problems with their kids. But it can keep both patients and therapists from getting to the all-important bottom of things.
Lack of curiosity is a dangerous thing–in medicine, therapy, culture. Trump’s manner of speaking certainly promotes “not knowing what you don’t want to know”. He is a disturbing model for over-simplified explanations and sneering at complexity or any level of sophistication or subtlety.