Posted by Toby on May 12, 1999, at 8:27:31
In reply to Re:topamax & dullness????, posted by Nancy on April 28, 1999, at 13:36:37
I don't want to be the big naysayer, but i would ask you to think a little about your doc's suggestion that you do research for him. Shrinks are just not supposed to have any kinds of dealings with their patients outside of the treatment relationship. It's an APA ehtical guideline. Psychiatrists have a fiduciary relationship with their patients, meaning a protective, nonexploitative relationship. The psychiatrist is not supposed to gain anything from the relationship other than a fee for services rendered and possibly an inner glow at seeing a patient do well. A social relationship, a work relationship, gifts, etc are just not supposed to develop because once a shrink has a vested interest in the patient other than professional, boundaries begin to blur and it becomes difficult for the doctor to see the patient's symptoms as symptoms, as problems to be remedied, and instead begins seeing the person as a friend or a business partner or employee or employer or whatever and once that point is reached, the doctor becomes useless as a therapist or even as a psychopharmacologist because the doctor is then treating the symptoms that bother him as they relate to his social interactions with the patient. This is why doctors are prohibited from treating family and friends. Of course, many doctors do treat family and friends and when this is discovered they often lose their license or at the very least have to go through alot of investigation and probation. And why? Because no matter how good the doctor is and no matter how wonderful their clinical judgement is, when it comes to family and friends, one cannot be properly objective and important symptoms will be missed just because they are familiar or minor symptoms will be overtreated because they annoy the doctor or because he can't say "no" now that he's been treating them for so long.
I've probably over-explained this, but I just want you to beware of the possible implications this could have on your treatment with him and/or your research work with him. What if you get well and start researching for him and then relapse and start doing poorly in your research? Is he in enough control of his feelings that he could see the symptoms returning early and not blame you for delayed publishing or faulty results and is he in enough control that this wouldn't bleed over into your psychiatric treatment? And if he had to let you go from the research job, could he still treat your illness effectively and could you still trust him with your treatment if you resented him terminating your job? And why did he spend so much time at your last appointment talking about what you could do for him rather than talking about your treatment? I realize you wanted to talk about it too because that is your interest, but for him, it is a slippery slope. Again, I want you to be able to return to your research and from your postings, I see your intelligence and am hopeful that this will be a reality for you, but I want you to be aware of the pitfalls of what your doctor proposed so you can make a good decision when the time comes.
poster:Toby
thread:5053
URL: http://www.dr-bob.org/babble/19990501/msgs/5995.html