sociatry91007b

[PATRICIA DESERT]

I am not working with the boy and don't know what else is in the mix or not.  But I routinely assess for these kinds of dynamics when I work with adults.  Colleagues I refer to do as well.  I assumed all therapists do.    

On the other hand, I find it interesting that a school administration implements a rule that clangs a bell and gives only 2 minutes for students to get to their next classes.  I love the image of that administration role playing students adhering to that rule.  Wouldn't that be something?  P.


----- Original Message ----- 
  From: Adam Blatner<mailto:adam at blatner.com> 
  To: PATRICIA DESERT<mailto:honeybwomn at msn.com> 
  Sent: Sunday, September 09, 2007 3:35 PM
  Subject: Re: sociatry91007b


  On the other hand, I'm imagining other scenarios: What if the one who told you the story may have distorted the actual event? 
         1. The parent was pressing with some urgency, and the doc may have simply mentioned that there exist medicines to reduce the intensity of panic.
             also, if the panic is intense, some short term benzodiazepines like Lorazepam can be very temporarily used to get over the short term.. and panic can be so very distressing...
             Also, 2. Possibly the doctor had every intention of doing a more thorough evaluation but the father used this as an excuse to avoid the confrontation with the slight possibility that the family is in denial, minimzing things...
       What if, as I mentioned, this boy isn't able to handle a level of higher level functioning that is the family's dream/expectation..

          So part of the game is to avoid too quickly demonizing the expert----a parental transference tendency we have towards authority figures, motivated also by envy---
               and recognize that victims often set up the scene in subtle devious ways so they can then enjoy the sympathy of others at what the mean doctor did. 
           
          Kids set up teachers versus parents, parents versus teachers, and other triangulations, in the game of  "Let's you and him fight." 

            None of this may be applicable to the case---I don't know how close you are to the scene---but I do include such considerations in my differential diagnosis.

       You have all inherited patients from previous therapists, along with stories about how that therapist was too this or that, and if you really talk with the therapist, you get a variety of experiences.
         Sometimes the therapist is as bad as the patient complained, if not worse;
               More often there have been some significant distortions
                   Not infrequently there is a true acting-out, escaping from the scene when the issues are getting close to the bone because the therapist in fact was doing a pretty good job... 
          again the use of triangulation if one parent (therapist) isn't willing or too lazy to check first with the other parent (therapist)... 

            Thoughts? Warmly, ADam
    ----- Original Message ----- 
    From: PATRICIA DESERT<mailto:honeybwomn at msn.com> 
    To: Adam Blatner<mailto:adam at blatner.com> 
    Sent: Sunday, September 09, 2007 2:39 PM
    Subject: Re: sociatry91007b


    By the way, the father of the boy suffering panic--he hung up on the psychiatrist soon as the doc recommended meds.   This man does not suffer fools lightly.  P.
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