Posted by Sigolene on October 10, 2000, at 14:07:10
In reply to Re: Misunderstandings » Sigolene » Cindy W, posted by Dr. Bob on October 9, 2000, at 13:59:17
> > > I think there's a big danger in exchanging between doctor and patient through internet. The danger is that the doc doesn't see the effect on the patient of what he says, at the moment the patient read the text.
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> That's right, the doctor gets less information and might misunderstand the patient...
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> > > As many psychiatric patients tend to make misinterpretations of intentions of others (due to his/her projections linked with bad early experiences), they are prone to misunderstand. For exemple they could interpret a simple neutral message as a rejection. Normally in face to face situation, the intention of the doc can be seen in his non verbal attitude.
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> And it goes the other way, too, the patient gets less information and might misunderstand the doctor.
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> > > Normally the sens of a message is at 80% given by non verbal attitude of the speaker.
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> People have asked me for a percentage, and I've told them I didn't know. Do others agree with 80%?
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> > > But if he don't have this info, the patient could think: he/she hates me, he don't want to talk with me and so on...and the patient in left alone with these feelings.
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> > I'd rather see a live human being, f2f, because that adds a lot for me (the unambiguous nonverbal cues, I guess, plus the feeling that a real live human being cares...
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> Thanks for raising those scenarios. One line of thinking might be that it's *helpful* for those cues to be missing. Because feeling hated or not cared about would be important to address. And if they met in person and there were cues that reassured the patient, those feelings might never be brought up.
What do you think?
> > BobHi Bob,
I think that a good therapist should be abble to be a little frustrating to the patient, in order to make the rejection feelings appear, and then talk about it. A little frustration, but not too much, otherwise the patient would go away and never come back. It's very difficult to find the right middle. This is a kind of "manipulation" of the patient. I think the most important quality of a good therapist is to be a good manipulator. First to establish a stong transference, and then to push a little on the weak points of the patient to make the defense mechanism appear. I think you know what i'm talking about.
All this is a long process which need first a face to face situation. But the internet communication could complete this process because it adds someting very important which is not mentionned in the hypothesis: It's the fact that there's things we can't tell directly to someone. It's easier to write them. Especially things regarding emotional feelings. When i will be a therapist i will just mention to my patients that i've an e-mail adress, and they can leave comments on it between therapy sessions if they have something to say...
Sigolène
poster:Sigolene
thread:844
URL: http://www.dr-bob.org/babble/social/20000813/msgs/930.html