Dear Dr. Brilliant Cliché,
I am a therapist and I wrestle with the philosophy “the customer is always right.” It comes to mind again after recently running into an ex-client of mine. I thought this person would still be seeing me if I had given them what they wanted. At that time, this client was engaged in some unethical practices and felt mildly guilty and conflicted about it. The client kept pushing to explore early childhood memories and a lot of Freudian crap. My impression at the time was that this person just wanted an excuse for this behavior and would use any justification to continue without guilt- “it’s not my fault, my parents screwed me up.” I had no sense that the client was interested in changing the unethical behavior but rather wanted a diagnosis to use as an excuse to continue.
Despite the reality that the psychiatric field often enables just this stance, my personal opinion was that it was bullshit. I refused, and after the client got tired of trying to manipulate me, they left my practice. I can’t help being allergic to denial but everyone else in my profession seems to think that the client would still be in treatment had I been more cooperative.
What is your take?
-Denial ain’t just a river
The old cliché “You can bring a horse to water but you can’t make him drink” comes to mind. What you are describing is someone’s innate personality.
Life is like a pond and every behavior a person chooses is a like rock being thrown into the waters- the ripples touch everyone else in that pond. The definition of an adult is “one who takes responsibility for the rocks they throw.” Your client was an adult by age but a child by nature. Unless a person really has an investment in change you cannot create that change. Therapy is a tool not a solution, just as medication is a tool not a solution.
If you had been “more cooperative,” your client would still be an adult child and you would be planning your vacation while listening to them. They say there is someone for everyone. This applies to therapy to0. There are plenty of therapists out there who will give this client exactly what they want. This will make the client temporally happy…until they get caught and the game changes.
I am sure you have plenty of clients more open to change and I would focus on them.
Dr. Brilliant Cliché
Granny says: In a large scale study conducted in the USA, it was discovered that very few doctors will stress the importance of lifestyle changes, such as weight loss, because if they do, the patients simply leave and look for another doctor who will give them the pill or schedule the operation that they want. This is one of the aspects of our health care system and national consciousness that goes up my butt sideways, because a huge percentage of physical problems exist specifically because of obesity and other poor lifestyle choices. But does anyone get up in arms about that? No. Instead, people get on their freaking’ soap boxes and rant about how we need more affordable insurance and lower prices for pharmaceuticals.
The namby pamby physicians in this country are being held hostage by the HMO’s, the pharmaceutical industry and the whining a__holes who eat their way up to 400 lbs and then are surprised when their knees give out. I know I’m probably going to get flack for this, but honest to god- it’s about time people started looking at the REAL health crisis in this country; most of us are idiots who are suffering needlessly because we indulge ourselves and have no sense of the consequences of our behavior. Good riddance to the patient. You may not get to Tahiti as often as the apathetic money grubbers who look the other way, but at least you can look at yourself in the mirror at night.