Save Your Marriage
(2) An intelligent, professionally successful, married father of two children sought treatment because of severe unhappiness associated with marital distress. His wife suffered from a serious mental illness that made her very difficult to live with. The 'Unhappy Husband' was committed to maintaining the marriage. A V code diagnosis 'Conditions not attributable to a mental disorder that are a focus of treatment' (DSM IIIR 359) (marital problem) was made. In 26 sessions of psychotherapy the man was able to clarify some of the pertinent dynamic issues in his marriage, and developed a number of adaptive strategies for lessening his distress. The 26 sessions were highly productive. Unhappy Husband wished that his treatment would be covered by insurance, but he agreed that he was not suffering from an illness and that it was fair to expect him to pay. (Buchanan et al. 2000 111 cf. the further cases in Daniels 1996 237-241).
In this final chapter I want to look at two situations that most family doctors will have had to face. The ethical issues do not arise from any modern technology but from a problem only too familiar to health professionals that families rarely enjoy the uncomplicated, easy, and unremittingly happy relationships that advertisements from the 1950s might lead you to expect.
What Are Some Common Causes Of Stress And Potential Causes Of Depression As Risk Factors For Coronary Heart Disease
Failed or broken relationships are a very common cause of stress, disappointment, and pain in people of all ages. One of the most painful experiences is divorce and marital breakdown, particularly when children are involved. It is stressful for the children, too, and can trigger major psychological disorders in any party. Some people never get over it. This chronic stress is recognized as a cause of heart disease.
It must be remembered then that intellectual property is the output of intellectual capital, just as innovation is the output of creative management and the production processes. As an output it cannot deliver competitive advantage. To remain competitive there must be an ongoing stream of intellectual property out-putted. The firm therefore depends on its intellectual capital to be maintained in order to create the competitive advantage it requires. Intellectual capital being vested in individuals creates a dilemma for the firm. It becomes an imperative then for the firm to institutionalize the intellectual capital, to either remove it from the individual or to create a long-term relationship between the individual and the firm.
(d) the existence of repression should not be rejected, but it cannot be accepted without question (e) recovered memories of childhood abuse may or may not be accurate, and independent corroboration is the only way of determining this (f) clinicians' responsibilities to their clients are best met through a cautious approach to the assumptions they make and the techniques they use and (g) clinicians' professional and ethical responsibilities are best met by avoiding an excessive encouragement or discouragement of reports of childhood sexual abuse. In a more concrete way, Knapp & VandeCreek (1996) commented on risk management procedures for psychologists treating individuals who recover memories of childhood abuse. They argued that 'effective treatment included maintaining appropriate boundaries, developing an accurate diagnosis that is based on a collaborative relationship with the patient, using intervention techniques that have been empirically derived or in other ways have received...
Psychotherapy is a highly skilled task. It requires considerable knowledge of different therapeutic modalities, how they work, what demands they make on the patient and whether they are effective for treating particular problems. Even when one's own style of assessment is influenced by psychoanalytic thinking, unless the patient has been specifically referred for this type of therapy the assessment that is carried out needs to reflect the therapist's openness to the possibility that an approach other than psychoanalytic therapy might be required. This poses a challenge since a traditional psychoanalytic assessment is unlikely to elicit the range of information that might be required to thoughtfully decide about the relative appropriateness of different therapeutic modalities. For example, a family therapist might be more interested in family composition, a cognitive therapist might want information about the patient's cognitions during a panic attack and a psychoanalytic therapist...
For patients to benefit from social support, the type of support offered must fit in with what the patient needs at that time. Unwanted or unhelpful support leads to negative affective states, diminished self-esteem, loss of autonomy, and decreased psychological well-being. New tensions within a relationship may emerge. Patients who receive little positive support at the same time that they receive a lot of unhelpful support from their friends and family are at highest risk for depression. At all periods of an illness, it is important to stress that patients must communicate clearly their feelings and needs for help, and that family and friends must learn to listen and respond to patients' needs, not their own. Patients experiencing a good deal of pain and disability are most affected by others' critical comments. Low levels of spousal support may be an indication of marital discord and deeper psychological problems, which may warrant psychological referral.
Shopping for healthcare services began in the 1980s. Prior to this, people visited the family doctor with whom they had grown up, or they selected a practitioner in the neighborhood. However, with the mobility that characterizes our society, people move frequently, and long-term relationships with healthcare providers are often not possible. Managed care has also impacted the sacred physician patient relationship physicians may be denied access to the care they think is best for an individual patient and patients may be forced to change physicians when they change employment or when health maintenance organization (HMO) physician panels change. Interest in holistic medicine and the proliferation of public information regarding the prevention of disease have also fueled the consumer-driven market.
Your relationship with the attorney with whom you are working is extremely important. Believe and trust him or her by giving him or her all your relevant theories so that he or she can decide whether and how to use them. I cannot remember ever having gone to trial without my attorney having questioned me at length. It is especially helpful when someone actually seats you at the witness stand during the lunch hour and browbeats you so that you will have experienced trial by fire. No one has ever refused to do this when I requested it, and the browbeating session was always more severe than the actual event. This is not a rehearsal for effective testimony rather, it is a means of seeing whether or how well you can hold everything together under duress, allowing you to become familiar with the possible worst-case scenario presented by opposing counsel.
Sexual dysfunction and sexually transmitted diseases are common they are not confined to young adults, or to promiscuous individuals. Although such topics are often avoided by patients because of embarrassment, it is particularly important to ask patients about sexual function and activity and if they have any of the disorders known to predispose to sexual dysfunction. These include diabetes mellitus, alcohol abuse, chronic renal failure, marital difficulty or psychological disorder. Similarly, when sexually transmitted diseases are suspected, e.g. IIIV. hepatitis or pelvic inflammatory disease, a careful sexual history should be undertaken. In females, dyspareunia (pain related to sexual intercourse) or failure to achieve an orgasm are common and are frequently caused by. or lead to. psychological difficulties. In males, loss of libido, premature ejaculation and inability to maintain an erection may also be primarily psychological. Questions should be asked objectively with tact and...
Savving Your Marriage
Do you need to save your troubled marriage? Save Your Marriage and Develop a Lifelong Love. If you are having trouble in your marriage, you are not alone.