Treatment Quotes

“I am dying from the treatment of too many physicians.”

“Early identification of patients who suffer from dissociative symptoms and disorders is essential for successful treatment, because these disorders do not resolve spontaneously. In addition, dissociative disorders are not alleviated by treatment directed toward an intercurrent disorder. However, because the dissociative disorders are among the few psychiatric syndromes that appear to respond favorably to appropriate treatment (Spiegel, 1993), improved accuracy in differential diagnosis is critical.”

“Anger is triggered by insult, then, and so is connected to worth (aretê) and to honour (timê). A person is insulted when the treatment he receives is worse than the treatment his worth entitles him to receive. He is honoured when he is given treatment proportional to his worth, and his worth is above or well-above average. When we speak of honour, therefore, we are in a way speaking of worth, since honour measures worth. Honour and insult are thus close to being polar opposites, and an insult is a harm to worth or honour.”

“Health care's not about insurance! Health care's about getting treatment.”

“It is interesting, in this context, to think again of our earlier argument that membership of the species Homo sapiens does not entitle a being to better treatment than a being at a similar mental level who is a member of a different species. We could also have said – except that it seemed too obvious to need saying – that membership of the species Homo sapiens is not a reason for giving a being worse treatment than a member of a different species. Yet in respect of euthanasia, this needs to be said. If your dog is ill and in pain with no chance of recovery, the humane thing to do is take her to the vet, who will end her suffering swiftly with a lethal injection. To ‘allow nature to take its course’, withholding treatment while your dog dies slowly and in distress over days, weeks or months, would obviously be wrong. It is only our misplaced respect for the doctrine of the sanctity of human life that prevents us from seeing that what it is obviously wrong to do to a dog, it is equally wrong to do to a human being who has never been able to express a view about such matters.”

“When people get used to preferential treatment, equal treatment seems like discrimination.”

“Among DID individuals, the sharing of conscious awareness between alters exists in varying degrees. I have seen cases where there has appeared to be no amnestic barriers between individual alters, where the host and alters appeared to be fully cognizant of each other. On the other hand, I have seen cases where the host was absolutely unaware of any alters despite clear evidence of their presence. In those cases, while the host was not aware of the alters, there were alters with an awareness of the host as well as having some limited awareness of at least a few other alters. So, according to my experience, there is a spectrum of shared consciousness in DID patients. From a therapeutic point of view, while treatment of patients without amnestic barriers differs in some ways from treatment of those with such barriers, the fundamental goal of therapy is the same: to support the healing of the early childhood trauma that gave rise to the dissociation and its attendant alters.Good DID therapy involves promoting co­-consciousness. With co-­consciousness, it is possible to begin teaching the patient’s system the value of cooperation among the alters. Enjoin them to emulate the spirit of a champion football team, with each member utilizing their full potential and working together to achieve a common goal.Returning to the patients that seemed to lack amnestic barriers, it is important to understand that such co-consciousness did not mean that the host and alters were well-­coordinated or living in harmony. If they were all in harmony, there would be no “dis­ease.” There would be little likelihood of a need or even desire for psychiatric intervention. It is when there is conflict between the host and/or among alters that treatment is needed.”

“Should you operate upon your clients as objects, you risk reducing them to less than human. Following the culture of appropriation and mastery your clients become a kind of extension of yourself, of your ego. In the appropriation and objectification mode, your clients’ well-being and success in treatment reflect well upon you. You “did” something to them, you made them well. You acted upon them and can take the credit for successful therapy or treatment. Conversely, if your clients flounder or regress, that reflects poorly on you. On this side of things the culture of appropriation and mastery says that you are not doing enough. You are not exerting enough influence, technique or therapeutic force. What anxiety this can breed for some clinicians! DBT offers a framework and tools for a treatment that allows clients to retain their full humanity. Through the practice of mindfulness, you can learn to cultivate a fuller presence to the moments of your life, and even with your clients and your work with them. This presence potentiates an encounter between two irreducible human beings, meeting professionally, of course, and meeting humanly. The dialectical framework, which embraces contradictions and gives you a way of seeing that life is pregnant with creative tensions, allows for your discovery of your limits and possibilities, gives you a way of seeing the dynamic nature of reality that is anything but sitting still; shows you that your identity grows from relationship with others, including those you help, that you are an irreducible human being encountering other irreducible human beings who exert influence upon you, even as you exert your own upon them. Even without clinical contrivance.”

“The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated.”