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it seemed to Kirsch that the most reliable guide to the mental landscape of a patient was the patient himself. He was better placed to explain his behaviour and his experiences than anyone else. Yet wherever Kirsch went, the patient was the very last person anyone thought to consult. Because, of course, the patient was insane.
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Doctor Johnson said, that in sickness there were three things that were material; the physician, the disease, and the patient: and if any two of these joined, then they get the victory; for, Ne Hercules quidem contra duos [Not even Hercules himself is a match for two]. If the physician and the patient join, then down goes the disease; for then the patient recovers: if the physician and the disease join, that is a strong disease; and the physician mistaking the cure, then down goes the patient: if the patient and the disease join, then down goes the physician; for he is discredited.
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One can envisage taking cells from a patient with sickle-cell anaemia or an inherited blood disorder and using the Cas9 system to fix the underlying genetic cause of the disease by putting those cells back into the patient and allowing them to make copies of themselves to support the patient's blood.
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Today I began to criticise myself and look at myself with a judgmental eye... but then instead of going all out in that direction, I stopped and I began to understand me. And then I began to be patient with me. And then I began to feel a softness in the middle of my chest. So then I concluded that I can understand and be patient with me, just like how I am always understanding and being patient with everyone else. Why? Because I deserve that, and more.
C. JoyBell C.
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When psychotherapy began, it was about the practitioner listening to a patient and interpreting what the patient said, in order to afford the patient insights about his or her psyche. But now we understand that the main curative part of psychotherapy is the relationship itself. It appears not to be relevant which psychology school the practitioner belongs to. What matters is the quality of the relationship and the practitioner's belief in what he or she is offering.
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Sometimes we mistake patience for weakness, but the patient person often realizes that it's much more important for another person to discover his or her own gifts and shortcomings-the patient person doesn't feel a need to "fix" other people, and sometimes will let certain things slide until the other person recognizes the problems. Patient parents often let their kids make the same mistake two or three times because they know that a lesson learned oneself is almost always preferable to a lesson given to us by an authority figure like a parent.
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I tell residents, if you gave me two patients with identical problems, and one of them had family at the bedside with a lot of laughter, plus photos and a quilt from home, and next door was another patient who was alone every time I came by - I'm going to be very nervous about the isolated patient's mental status.
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THE MAXIMS OF MEDICINE Before you examine the body of a patient, Be patient to learn his story. For once you learn his story, You will also come to know His body. Before you diagnose any sickness, Make sure there is no sickness in the mind or heart. For the emotions in a man's moon or sun, Can point to the sickness in Any one of his other parts. Before you treat a man with a condition, Know that not all cures can heal all people. For the chemistry that works on one patient, May not work for the next, Because even medicine has its own Conditions. Before asserting a prognosis on any patient, Always be objective and never subjective. For telling a man that he will win the treasure of life, But then later discovering that he will lose, Will harm him more than by telling him That he may lose, But then he wins. THE MAXIMS OF MEDICINE by Suzy Kassem
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I use a portable pocket ultrasound device instead of a stethoscope to listen to the heart, and I share it with the patient in real time. 'Look at your valve, look at your heart-muscle strength.' So they're looking at it with me. Normally a patient is tested by an ultrasonographer who is not allowed to tell them anything.
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Be patient with everyone, but above all with yourself. I mean do not be disheartened by your imperfections, but always rise up with fresh courage. How are we to be patient in dealing with our neighbour's faults if we are impatient in dealing with our own? He who is fretted by his own failings will not correct them. All profitable correction comes from a calm and peaceful mind.
Saint Francis de Sales
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In the patient who succumbed, the cause of death was evidently something which was not found in the patient who recovered; this something we must determine, and then we can act on the phenomena or recognize and foresee them accurately. But not by statistics shall we succeed in this; never have statistics taught anything, and never can they teach anything about the nature of the phenomenon.
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He is not truly patient who will only suffer as far as seems right to him and from whom he pleases. The truly patient man considers not by whom he is tried, one above him, or by an equal, or by an inferior, whether by a good and holy man or by a perverse and unworthy, but from every creature. He gratefully accepts all from the hand of God and counts it gain.
Thomas e Kempis
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The psychiatric interviewer is supposed to be doing three things: considering what the patient could mean by what he says; considering how he himself can best phrase what he wishes to communicate to the patient; and, at the same time, observing the general pattern of the events being communicated. In addition to that, to make notes which will be of more than evocative value, or come anywhere near being a verbatim record of what is said, in my opinion is beyond the capacity of most human beings.
Harry Stack Sullivan
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Most therapists do not appear to know how to pinpoint and reverse therapeutic resistance - to head it off at the pass. Instead, they try to persuade the patient to change, or to do the psychotherapy homework, while the patient resists and 'yes-butts' the therapist. The therapist ends up feeling frustrated and resentful, and doing all the work.
David D. Burns
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At first the analysing physician could do no more than discover the unconscious material that was concealed from the patient, put it together, and, at the right moment, communicate it to him. Psychoanalysis was then first and foremost an art of interpreting. Since this did not solve the therapeutic problem, a further aim quickly came in view: to oblige the patient to confirm the analyst's construction from his own memory.
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As a child, I probably knew phrases that other children didn't known, like "pitocin drip" or "myocardial infarction." Some kind of knowledge was always in the air. My parents would always talk about science at the dinner table, saying something about this patient or some other patient. So I guess for a nanosecond in early high school, I thought about going into medicine.
M. Night Shyamalan
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A physician who fails to enter the body of a patient with the lamp of knowledge and understanding can never treat diseases. He should first study all the factors, including environment, which influence a patient's disease, and then prescribe treatment. It is more important to prevent the occurrence of disease than to seek a cure
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I hope that I have gained some wisdom, but I don't know. I have kids, and that certainly puts things into perspective. I think I'm a more patient person. I hope I'm a more patient person. I'm a little more relaxed about the peripheral side of this business, which I used to find very confusing and alarming.
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Competition makes things come out right. Well, what does that mean in health care? More hospitals so they compete with each other. More doctors compete with each other. More pharmaceutical companies. We set up war. Wait a minute, let's talk about the patient. The patient doesn't need a war.
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I hate those TV shows where characters talk about one thing, such as their patient on the operation table (let's say they're a doctor), then you realize they're actually talking about actually talking about themselves. The patient's open-heart surgery is nothing compared to their own messed-up heart or whatever. It's selfish. And means they're not concentrating, which is medical negligence.
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The freedom of patient speech is necessary if the doctor is to get clues about the medical enigma before him. If the patient is inhibited, or cut off prematurely, or constrained into one path of discussion, then the doctor may not be told something vital. Observers have noted that, on average, physicians interrupt patients within eighteen seconds of when they begin telling their story.
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His outflung hands traced over the threads of his rug, passed loop by loop through some patient woman's hands. Or maybe she hadn't been patient. Maybe she'd been tired, or irritated, or distracted, or hungry, or angry. Maybe she had been dying. But her hands had kept moving, all the same.
Lois McMaster Bujold
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Some authors have conceptualized depression as a "depletion syndrome" because of the prominence of fatigability; they postulate that the patient exhausts his available energy during the period prior to the onset of the depression and that the depressed state represents a kind of hibernation, during which the patient gradually builds up a new story of energy.
Aaron T. Beck
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Some people with DID present their narratives of sadistic abuse in a quite matter-of-fact way, without perceptible affect. This may sometimes be done as a way of protecting themselves, and the listener, from the emotional impact of their experience. We have found that people describing trauma in a flat way, without feeling, are usually those who have been more chronically abused, while those with affect still have a sense of self that can observe the tragedy of betrayal and have feelings about it. In some cases, this deadpan presentation can also be the result of cult training and brainwashing. Unfortunately, when a patient describes a traumatic experience without showing any apparent emotion, it can make the listener doubt whether the patient is telling the truth. (page 119, Chapter 9, Some clinical implications of believing or not believing the patient)
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I think it perfectly just, that he who, from the love of experiment, quits an approved for an uncertain practice, should suffer the full penalty of Egyptian law against medical innovation; as I would consign to the pillory, the wretch, who out of regard to his character, that is, to his fees, should follow the routine, when, from constant experience he is sure that his patient will die under it, provided any, not inhuman, deviation would give his patient a chance.
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Remember. You are a physician. You are not a policeman nor are you a minister of religion. You must take people as they come. Remember, too that though you will generally know more about the condition than the patient, it is the patient who has the condition and this if nothing else bestows on him or her a kind of wisdom. You have the knowledge but that does not entitle you to be superior. Knowledge makes you the servant not the master.
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Every session attended by the analyst must have no history and no future. What is 'known' about the patient is of no further consequence: it is either false or irrelevant. If it is 'known' by patient and analyst, it is obsolete....The only point of importance in any session is the unknown. Nothing must be allowed to distract from intuiting that. In any session, evolution takes place. Out of the darkness and formlessness something evolves.
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Patience A word so difficult to pronounce because it is so difficult to wait or to be patient. But no matter how someone is behaving, appreciate the grace you have for God to give you people that will build that character in you!! It isn't easy but for the Christ like being, it is joy overwhelming. Thank and praise God for every situations that require you to be patient. God bless you.
Jean Faustin Louembe
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Karma is the beginning of knowledge. Next is patience. Patience is very important. The strong are the patient ones, Anjin-san. patience means holding back your inclination to the seven emotions: hate, adoration, joy, anxiety, anger, grief, fear. If you don't give way to the seven, you're patient, then you'll soon understand all manner of things and be in harmony with Eternity.
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Love: A temporary insanity curable by marriage or by the removal of the patient from the influences under which he incurred the disorder. This disease, like caries and many other ailments, is prevalent only among civilized races living under artificial conditions; barbarous nations breathing pure air and eating simple food enjoy immunity from its ravages. It is sometimes fatal, but more frequently to the physician than to the patient.
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LOVE, n. A temporary insanity curable by marriage or by removal of the patient from the influences under which he incurred the disorder. This disease, like _caries_ and many other ailments, is prevalent only among civilized races living under artificial conditions; barbarous nations breathing pure air and eating simple food enjoy immunity from its ravages. It is sometimes fatal, but more frequently to the physician than to the patient.
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He, who for an ordinary cause, resigns the fate of his patient to mercury, is a vile enemy to the sick; and, if he is tolerably popular, will, in one successful season, have paved the way for the business of life, for he has enough to do, ever afterward, to stop the mercurial breach of the constitutions of his dilapidated patients. He has thrown himself in fearful proximity to death, and has now to fight him at arm's length as long as the patient maintains a miserable existence.
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I believe I have said this before, but it's worth repeating. The patient's resources stop where the therapist's beliefs stop. It is critical that the therapist have an open mind and complete faith in the patient's deeper resources. The most formidable and potent resources must be approached with respect, taken seriously and accepted on faith. Understand the information and knowledge shared with the therapist is entirely dependent on his or her level of development, their ability to properly use what is communicated for the patient's or therapist's benefit and welfare, and the level of trust and belief the resource has in the therapist. The success of their bond and their mission is founded on mutual trust, respect, and faith in each others abilities and potentials. Remember this!' The Guardian
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At first I thought, if I were Superman, a perfect secret identity would be "Clark Kent, Dentist," because you could save money on tooth X-rays. But then I thought, if a patient said, "How's my back tooth?" and you just looked at it with your X-ray vision and said, "Oh it's okay," then the patient would probably say, "Aren't you going to take an X-ray, stupid?" and you'd say, "Aw, get outta here," and then he probably wouldn't even pay his bill.
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A patient doesn't select his physical ailments. They happen to him. You could just as well ask when you are eaten by a crocodile, 'How did you select that crocodile?'. Nonsense. He has selected you. The patient doesn't even select the symptoms unconsciously. That is an extraordinary exaggeration of the subject to say he was choosing such things. They get him.
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It has been fashionable in some psychiatric and lay circles to blame the mother for whatever goes wrong in development. [... ] If blame must be assessed it should be placed on the human condition which requires such prolonged dependence on one individual for development to take place. This makes the child extraordinarily vulnerable to the idiosyncrasies of that person (the mother). On the other hand, the prolonged dependence on this relationship also provides the potential for the richness of the human personality. It is a mistake, in my judgment, in psychotherapy to encourage or side with the patient's hostility to the mother. The patient has to become aware of and express it in therapy in order to grow but whatever the source of this hostility is in the past - be it an actual memory or a fantasy to rationalize a feeling state - the problem is now the patient's responsibility and he must work it out.
James F. Masterson
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Let the surgeon take care to regulate the whole regimen of the patient's life for joy and happiness by promising that he will soon be well, by allowing his relatives and special friends to cheer him and by having someone tell him jokes, and let him be solaced also by music on the viol or psaltery. The surgeon must forbid anger, hatred, and sadness in the patient, and remind him that the body grows fat from joy and thin from sadness.
Henri de Mondeville
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On Prozac, Sisyphus might well push the boulder back up the mountain with more enthusiasm and creativity. I do not want to deny the benefits of psychoactive medication. I just want to point out that Sisyphus is not a patient with a mental health problem. To see him as a patient with a mental health problem is to ignore certain larger aspects of his predicament connected to boulders, mountains, and eternity.
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Past and history are not the same. Past is what happened. It consists of events that affected the patient's self, some of which he can remember, but the most he is having trouble remembering. History is transforming the past to a story that the person tells himself. Sometimes, the story stems from the past, but even the most sincere patient's history is more like a myth. (Translated from the Hebrew edition).
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I look upon a good physician, not so properly as a servant to nature, as one, that is a counsellor and friendly assistant, who, in his patient's body, furthers those motions and other things, that he judges conducive to the welfare and recovery of it; but as to those, that he perceives likely to be hurtful, either by increasing the disease, or otherwise endangering the patient, he thinks it is his part to oppose or hinder, though nature do manifestly enough seem to endeavour the exercising or carrying on those hurtful motions.
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The desire of advising has a very extensive prevalence; and, since advice cannot be given but to those that will hear it, a patient listener is necessary to the accommodation of all those who desire to be confirmed in the opinion of their own wisdom: a patient listener, however, is not always to be had; the present age, whatever age is present, is so vitiated and disordered, that young people are readier to talk than to attend, and good counsel is only thrown away upon those who are full of their own perfections.
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Patients with complex trauma may at times develop extreme reactions to something the therapist has said or not said, done or not done. It is wise to anticipate this in advance, and perhaps to note this anticipation in initial communications with the patient. For example, one may say something like, "It is likely in our work together, there will be a time or times when you will feel angry with me, disappointed with me, or that I have failed you. We should except this and not be surprised if and when it happens, which it probably will." It is also vital to emphasize to the patient that despite the diagnosis and experience of dividedness, the whole person is responsible and will be held responsible for the acts of any part. p174
Elizabeth F. Howell
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