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this post was submitted on 13 Sep 2024
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chapotraphouse
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Could you please describe a "bad patient"? Like, how can there be such a thing by definition? A psychologist, as any other medical practitioner, should be able to form a diagnosis based on the observation and listening to the patient, and then decide which treatment, if any, is adequate. How is any of this the responsibility, or even worse, fault, of the patient???
Lying about yourself, missing appointments, not sticking to treatments, general contempt for the process while trying to go through it.
Lots of ways someone can poison their own well.
My moms a narcissist and actually got worse after going to therapy. She does her appointments remote and one time she was staying at my place during one. I wasn't trying to eavesdrop but the walls are thin and I overheard a bit where she was recounting an interaction she had with my sister that I had witnessed and she told the tale in a way that made her come off WAY more reasonable than my sister way less reasonable than I recall. I never called this out, felt it would be unethical of me to do so, but it always made me suspicious he was basically just using her therapist to validate her interpretations of things.
I imagine this happens to some extend with almost all therapy, your therapist is naturally only gonna get your side of every story, but I see how with certain toxic people (like a narcissist) it could actually end up so bad it's counter productive.
Yeah. Definitely a part of it. Therapists aren't infallible. If people are actively trying to deceive them in order to achieve an outcome, it's not always on the therapist. Sometimes they're really, really good at it.
Did you ever see that scene in The Sopranos about this?
THE SOPRANOS - MELFI discovers the truth about criminals
I found a YouTube link in your comment. Here are links to the same video on alternative frontends that protect your privacy:
That's, in my humble opinion, a fault of the system that makes people disregard the opinion of the professionals, or of the field failing to compel patients to actually conform to the therapy mode chosen or to adapt to the needs of the patient. Your "bad patient" thing sounds to me very much like "everyone complains about bad teachers but nobody wants to admit that there are bad students". Like, maybe adapt the system and the field to diverse people in diverse situations, instead of applying a cookie-mold approach and blaming the recipient for it.
How are you going to compel people to conform to the therapy?
You can drag a horse to water. You can't make it drink.
Again, that should absolutely be studied as part of the effectiveness of given therapies and methodologies. If the field fails to account for the high percentage of people who don't confirm to therapies for one reason or another, or to study those reasons and to find solutions, then what the fuck are the scientists doing?
I’m not going to say that the methodology doesn’t matter, but the #1 factor in whether therapy is going to work for someone is the level of trust with the therapist. That tops methodology, education, everything else. Certain therapies absolutely help certain things, but a good therapist isn’t trying to get anyone to “conform.”
Read the rest of my interactions with the other user in this comment chain
I did that before I responded. Sorry to interject if it didn’t fit.
Oh no, all good, just wanted to say that I've mostly addressed it in my other interactions
It is studied as a part of the effectiveness. Nobody claimed that there is a high percentage of bad patients. Just that they exist.
The focus on "bad patients" is faulty from a pragmatic point of view. It leads to thinking "certain people just don't wanna be helped". If you reframe it as people who for example by social conditioning or by public opinion or trust on psychology, don't fully accept treatment, or people who for actual reasons aren't receptive to treatment, the framing leads you to finding solutions to those problems instead of just dismissing them as "bad patients", as happens with students. I bet my ass that "bad patients" correlate with demographic and economic factors, i.e., "bad patients" are a product of the environment that can be fixed by altering the environment in a very similar fashion to how "criminals" are a overwhelmingly byproduct of the system and surrounding conditions.
Automatically assuming that bad patients don't exist is faulty in and of itself. Of course some people don't want to be helped - Not everyone is ready to be helped, and not everyone thinks that they need to be "helped". You cannot help someone that doesn't want to be helped.
Again, focusing on "bad patients" instead of the environment that creates them, is like focusing on "criminals" instead of their surrounding socioeconomic environment
Nobody is focusing on them. Just admitting that they exist.
Yeah the behaviours you mentioned are a sign of a "difficult" patient (not the individual therapist's fault nor the patient's fault), not a "bad" patient. A "bad" patient cannot exist because the goal is a constant never-ending striving to get as close to 100% of the population healthy no matter what. Saying "what can we do, x% are morally bad so fuck em they deserve to suffer unless they become good" is neoliberal thinking and unacceptable.
Furthermore, such behaviours are indicative moreso of a sick society which tries to compartmentalize the healing of a person's mental illness to a paid hourly visit per week and does fuck all to collectively address any compounding factors that may exacerbate their condition, nor try and help them further, outside of this relationship.
you're fuckin suss
there are definitely well meaning people with bad therapists
this does not mean that bad patients don't also exist
Admitting that bad patients exist doesn't automatically erase the shitty experiences that other people have.
Absolutely! Automatically writing people off isn't a great strategy, especially for therapy.