Specificity in Psychiatric Treatment

Abstract

Every standup comic has a routine about a man going to a dentist, and the doctor, mistaking him for another patient, extracts the wrong tooth. This usually evokes gales of laughter from the audience, because they can so readily identify with the situation in this day of impersonalization. Unhappily, the "wrong" patient is sometimes seen in psychiatric treatment as well. Consider the man referred to a psychiatrist because of depression, job-adjustment difficulties, and periods of sexual impotence. He is single, 30, in good physical health, and has had individual psychotherapy previously for several years without significant benefit. After interviewing the patient alone, and listening to his story, the therapist decides to see him together with his entire family. The psychiatrist discovers that this man's father is a brutal, denigrating individual, who has always castigated his son. The father says repeatedly, "The only thing wrong with him is that he's lazy."