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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by GeneLady on August 11, 2008, at 1:05:39
What is the responsibility of a psychologist to the spouse of his patient? In this case the husband has a history of bipolar, addictions, sometimes abusive, mild dementia and neurological disease. I guess for that matter, what is the responsibility of the spouse to the psychologist when the psych and spouse and patient have met together a few times?
Posted by Phillipa on August 11, 2008, at 11:03:33
In reply to Responsibility of psych to spouse, posted by GeneLady on August 11, 2008, at 1:05:39
Unless he's a patient of that T I have been told none. But that is here. Phillipa
Posted by Dinah on August 11, 2008, at 11:12:10
In reply to Responsibility of psych to spouse, posted by GeneLady on August 11, 2008, at 1:05:39
What do you mean by responsibility? The husband is the patient? Do you mean does the psychologist have a responsibility to make sure the spouse is not in danger? I think that if there is an immediate threat to another, the psychologist has to report that.
In other ways, the psychologist's primary concern is the client and he has to act in the client's best interests.
Posted by GeneLady on August 11, 2008, at 17:48:46
In reply to Re: Responsibility of psych to spouse » GeneLady, posted by Dinah on August 11, 2008, at 11:12:10
I guess that what I'm looking for and in a sense requesting from the psych is a bit unusual. For that matter, I'm not particularly even complaining ... just sort've mulling things over in my mind. Not quite sure where to go or what to do.
Because of the mental status (including a certain amount of dementia caused by a neurological disease) my husband often believes erroneously that people are mean to him or the world is a bad place, etc. i.e., he doesn't have all the mental tools to deal with it (sort it out) effectively and never will have. He lashes out and is sometimes mean.
Obviously that is of considerable distress to me especially since he is/was very intelligent. In a sense, it is in his best interests that I am "treated" or at least engaged in some kind of meaningful/theraputic relationship with the psychologist in order to maintain my own sanity and maintain a life for both of us. I do believe it helps the psych to know what's going on in real life also. I feel that despite the standard opinions that the psychologist has a responsibility to me. Going to a separate therapist has been a miserable failure especially since most do not understand this rare disease.
The psychologist is in many ways a nice guy and I "love" him (in a sense) and has told me that I can come whenever I want to. I'm trying not to overdo it. The psych has pushed me to the point that we've gotten into yelling matches but I think that was intentional ... he was looking for my response for some reason (what is it?) In a way I feel slightly guilty as if I'm taking advantage of the psych but at the same time don't really think I am. I doubt he would let me.
These situations in which one person has some incapacity are so complex ... and so emotional.
> What do you mean by responsibility? The husband is the patient? Do you mean does the psychologist have a responsibility to make sure the spouse is not in danger? I think that if there is an immediate threat to another, the psychologist has to report that.
>
> In other ways, the psychologist's primary concern is the client and he has to act in the client's best interests.
Posted by Dinah on August 11, 2008, at 18:02:38
In reply to Re: Responsibility of psych to spouse » Dinah, posted by GeneLady on August 11, 2008, at 17:48:46
I'd sort this out with the psychologist. My understanding is that while he may talk to you as well, and help you in dealing with your husband, and while he may well wish to hear what's going on in your husband's life, if he is your husband's therapist his responsibility is to your husband. There is a shadow of conflict of interest if he is a therapist to both of you. Some therapists would mind more than others. But there are sensible logical reasons (such as a divorce and legal proceedings) that could make being a therapist to two spouses unwise.
My son sees a therapist at times, and she occasionally speaks to my husband and me. She's always willing to take our calls, and find out what's going on in his life. She'll talk to us about any marital issues she happens to see. But push come to shove, she's his therapist not ours. If he tells her something that we probably should know, but that she is not ethically responsible for telling us, she's not going to be able to tell us. Her responsibility is to him. She can try to convince him to tell us, but he is her client.
I'd clarify with the psychologist the exact parameters. Otherwise it could lead to some disappointment down the line. It might be difficult to have two separate psychologists, but if it's individual therapy, not marriage therapy, it might be better. Maybe they could confer. Or maybe he would be comfortable with the situation. I don't know the exact parameters so don't know what issues would be involved. If you'd like him to be your therapist as well, it's probably best to say so up front and see what he says.
Posted by GeneLady on January 2, 2009, at 0:54:39
In reply to Re: Responsibility of psych to spouse » GeneLady, posted by Dinah on August 11, 2008, at 18:02:38
In a sense, the bottom line is that when the patient has dementia and a significant mood disorder then in my opinion some of the traditional functions of a therapist are no longer relevant. Fortunately this guy does to some extent seem to be interested in my welfare but part of that is a [welcomed] tool to get my spouse to notice what's happening to me, I would say. Wise T.
The T has finally told me directly and privately that my hubby is hard to deal with (for me) and especially so when he goes on his rampages. That was good to hear because it took many years for a T to really get below the surface with my H. Marriage counseling is a waste of time with someone who's just plain not all there.
I will not be going to a T - it was a waste of $ and years and in many ways created a situation in which I was worse off. Ethics aren't always what they should be in T's. Neither is competence. What's most important now in my opinion is to get my H under control and help me to know how to deal with him. Wonder if there are any books on that specifically? The psychiatrist, although a nice guy, just gives out passive platitudes like "just support him and help him to feel better" which is just useless. Also, I need to spend more time and effort feeling good about my life and carrying out my career and interests. That's really a challenge in someone who has mild dementia.
> I'd sort this out with the psychologist. My understanding is that while he may talk to you as well, and help you in dealing with your husband, and while he may well wish to hear what's going on in your husband's life, if he is your husband's therapist his responsibility is to your husband. There is a shadow of conflict of interest if he is a therapist to both of you. Some therapists would mind more than others. But there are sensible logical reasons (such as a divorce and legal proceedings) that could make being a therapist to two spouses unwise.
>
> My son sees a therapist at times, and she occasionally speaks to my husband and me. She's always willing to take our calls, and find out what's going on in his life. She'll talk to us about any marital issues she happens to see. But push come to shove, she's his therapist not ours. If he tells her something that we probably should know, but that she is not ethically responsible for telling us, she's not going to be able to tell us. Her responsibility is to him. She can try to convince him to tell us, but he is her client.
>
> I'd clarify with the psychologist the exact parameters. Otherwise it could lead to some disappointment down the line. It might be difficult to have two separate psychologists, but if it's individual therapy, not marriage therapy, it might be better. Maybe they could confer. Or maybe he would be comfortable with the situation. I don't know the exact parameters so don't know what issues would be involved. If you'd like him to be your therapist as well, it's probably best to say so up front and see what he says.
This is the end of the thread.
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