Autobiography of an alcoholic medical student.
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Many therapists find working with adolescents to be a difficult and unrewarding task. Drawing on the ideas of solution-oriented therapy and the narrative approaches to counseling, the authors provide a framework for cooperative, therapeutic work with adolescents. Strategies which enable therapists to gain an understanding of the world view of adolescents by listening to their stories are discussed. By hearing and understanding the stories adolescents tell about their lives, therapists can recognize and tap into the strengths and resources of these young persons.
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Although agoraphobia includes distinct symptoms of avoidant and dependent personality disorder, it is currently classified as a form of "anxiety disorder." Such categorization seems to imply that uncontrolled panic attacks sometimes generate subsequent avoidant and dependent traits, leading afflicted persons to virtually seclude themselves in the home. The authors propose an alternate view, suggesting that in many cases the etiology of the disorder can be attributed to a predisposing antecedent character structure. The initial panic attacks are triggered by a stressor, but patients can then use these symptoms to further intensify and justify avoidant and dependent behavior. This paper features the autobiographical account of an agoraphobic woman who seldom comes to the clinic for therapy, and never on her own. The "fear of fear" characteristic of agoraphobia is readily traced in her history to a family background in which she was conditioned to feel that she could not manage without the direct support of her father.
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Comparing a patient's diary with a nurse's diary can illustrate the impact of care from the patient's perspective. This is a useful way of introducing experimental learning to students.