Off The Tracks

Berman, Jeffrey; Mosher, Paul W

ISBN 10: 1949093158 / ISBN 13: 9781949093155

Published by Ipbooks, 2019

About this Item

Seller Inventory # 35170773-n

Bibliographic Details

• Title: Off The Tracks
• Publisher: Ipbooks
• Publication Date: 2019
• Language: English
• ISBN 10: 1949093158
• ISBN 13: 9781949093155
• Binding: Soft cover
• Condition: New

About this title

Synopsis

Psychiatry has much in common with the irresistible little girl Henry Wadsworth Longfellow immortalized in a poem that became a household nursery rhyme: “When she was good, she was very good indeed, / But when she was bad she was horrid.” The same can be said for the mental health profession.

Despite numerous advances in the past century, the treatment of mental disorders is still in a rudimentary state due to our fundamental lack of understanding of the complex causes of some of its daunting problems. Most mental health professionals now believe that both psychological (psychodynamic) and physical (inherited or biomedical)
factors combine in varying proportions to undermine a person’s state of emotional well-being. Most experts also believe that an optimal combination of psychological and physical treatments will provide for many patients the best chance of recovery. Across this wide spectrum of possible combinations, the one factor that appears to be most crucial to recovery is the treatment relationship.

Many studies of purely psychological treatments have shown that the treatment relationship is the single most  important variable in  determining therapy outcome. “The therapy relationship accounts for why clients improve—or fail to improve—as much as the particular treatment method,” a major review of “Evidence-Based Therapy
Relationships” concludes. Thousands of qualitative and quantitative studies have demonstrated that about 75–80% of patients who enter psychotherapy show improvement, a treatment outcome well above that of many medical procedures. It is self-evident, then, that the treatment relationship must be a powerful force in and of itself. Like any powerful force, the management or mismanagement of the treatment relationship can bring great benefit or harm to the patient. Off the Tracks: Cautionary Tales About the Derailing of Mental Health Care presents dramatic examples, across a broad range of theoretical approaches to mental health care, where the treatment relationship was mismanaged in such a way as to harm mentally ill patients. We are not presenting these examples to condemn psychoanalytic, psychiatric or psychological treatments, but rather to show how these cautionary tales
indicate the necessity of self-monitoring and self-regulation by members of the mental health profession. Because we speak here of a relationship, the extent to which the personality of the therapist is implicated makes
the requirements of the therapist unique in the world of health care. We are not limiting ourselves only to the role of the therapist in purely psychological treatments. In the realm of predominantly physical treatments of mental disorders, clinicians delivering the treatment are psychotherapists as well. Clinicians’ judgments in choosing a physical approach or a pharmacological agent, determining its frequency or dose, or even deciding how often they see their patients, are clearly related to the relationship as much as to the underlying scientific theory supposedly governing such choices .

Review

“Psychoanalysis has been plagued by errant and abusive practitioners since its inception. In this outstanding new volume, Jeffrey Berman and Paul Mosher have traced the history of sexual boundary violations in great detail. Their meticulous research into appalling cases of analyst misconduct in the consulting room (and elsewhere) makes for a fascinating and chilling read. The siren song of counter-transference requires systematic processing by the analyst, hopefully in consultation with a trusted colleague. We are all vulnerable to self-deception. Hence psychoanalysts and psychotherapists should read this book, which is the most thorough history of analysis going
awry that has ever been published. I highly recommend it"
—GLEN O. GABBARD, Clinical Professor of Psychiatry at Baylor College of Medicine in Houston, Texas, and Training & Supervising Analyst at the Center for Psychoanalytic Studies in Houston.

“Psychiatric treatment has the potential of immense good. That results from the combination of the psychological power of the therapist and the vulnerability of the patient. However that power, and that vulnerability, can also lead to great evil. Berman and Mosher have assembled some startling and horrible examples of the several ways in which that evil may occur. Sick or criminal doctors, foolish patients, sexual temptations, financial temptations, and the disturbing recurrent tendency of the profession to deny its problems, or at least to keep them to itself, are culpable. The authors have done the community and the mental health profession an immense service—
bringing light and fresh air to what has long been kept secret. Their meticulous research and gift at storytelling brings us tales of rape, theft and unbridled grandiosity. These reflect universal human themes that will no doubt continue, but thanks to Berman, Mosher and others like them, the profession’s primary loyalty is shifting from shielding its bad seeds to protecting its patients.”
—ROBERT MICHELS, Former Chair, Department of Psychiatry Former Dean and Provost for Medical Affairs
Cornell University Medical College

“A brilliant, erudite, comprehensive and enthralling account of the history of boundary violations of both sexual and non-sexual kinds. The account reveals the narcissism and entitlement of the violators along with the often inadequate responses to their egregious unethical activities. These case studies are lessons from the past not to be ignored today.” —DOUGLAS KIRSNER, Emeritus Professor of Philosophy & Psychoanalytic Studies at
Deakin University, Melbourne, Australia,