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Therapists should convey that they care - By James Dobson

June 12, 1997|By James Dobson

Question: I have suffered from low self-esteem for years, so I sought help from a psychiatrist during a particularly depressed period of my life. Rather than building my self-worth, however, he was cold and aloof with me. I had the feeling he was merely doing a job and never really cared about me. How would you approach a patient with my kind of problem?

Dr. Dobson: It has been discouraging for me to see how often my professional colleagues (psychiatrists, psychologists and counselors) have overlooked the feelings you described as a most obvious root cause for emotional distress. Lack of self-esteem produces more symptoms of psychiatric disorders than any other factor yet identified.

Time and time again in my casework as a psychologist, I sat talking to a person with deep longings to be respected and accepted. How badly he needed human affection and kindness, as well as emotional support and suggestions for change. Yet if that same needy patient had gone to Dr. Sigmund Freud in his day, the immortal grandfather of psychoanalysis would have sat back in detached professionalism, analyzing the patient's sexual repressions.

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If the patient had sought treatment from Dr. Arthur Janov, originator of Primal Scream therapy, he would have been encouraged to roll on the floor and bawl like a baby. Other modern therapists would have required the same patient to assault and be assaulted by other members of an "encounter group" or remove his clothing in a group.

Believe it or not, one of the major areas of controversy at psychiatric conferences a few years ago involved the wisdom of female patients having sexual intercourse with their male therapists! Have we gone completely mad? Whenever men abandon their ethics, they cease to make sense, regardless of their professional degrees and licenses.

The most successful approach to therapy for a broken patient, I firmly believe, is to convey the following message with conviction: "Life has been tough, and you have become acquainted with pain. To this point, you've faced your problems without much human support, and there have been times when your despair has been overwhelming. Let me now share that burden. From this moment forward, I am interested in you as a person; you deserve and shall have my respect. As best as possible, I want you to quit worrying about your troubles. Instead, confide them to me. Our concentration will be on the present and the future; together we will seek appropriate solutions."

Suddenly, the beleaguered patient no longer feels alone - the most depressing of human experiences. "Someone cares! Someone understands! Someone assures me with professional confidence that he is certain I will survive. I'm not going to drown in this sea of despondence, as I feared. I have been thrown a life preserver by a friend who promises not to abandon me in the storm."

James Dobson is a psychologist, author and president of Focus on the Family, a nonprofit organization dedicated to the preservation of the home. Write to him in care of The Herald-Mail Co., P.O. Box 439, Hagerstown, Md. 21741.

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