Who am I to Treat This Seriously Disturbed Person? (2016)

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Length: 1 hour

Bertram P. Karon, PhD, ABPP

Who am I to treat this person? That's what came to mind every time I treated a seriously disturbed person. I don't know enough and I have hangups. But no one knows enough, and every therapist has hangups, although our own analysis helps. We may feel confused, frightened, angry, or hopeless because these are the patient’s feelings. Discussed are creating rational hope, dealing with feelings (including terror), depression, delusions, hallucinations, and suicidal and homicidal dangers. Theory is helpful, but it is not enough. Tolerating not knowing often leads to effective improvisations. Best results were obtained with psychoanalysis, or psychoanalytic therapy, without medication. Next best was psychoanalytic therapy with initial medication withdrawn as rapidly as the patient can tolerate. Electroconvulsive therapy is discouraged.

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