nuthinbutpink
December 31st, 2010, 12:29 PM
By Dean F. MacKinnon, M.D.
Dec 30, 2010
I begin with a dark bit of humor: a cartoon cliché, with a man lying on a psychiatrist's couch. The man says, "All my friends think I'm crazy." The psychiatrist replies, "Why don't you kill them?"
Why is this funny? To me it's funny because it gets to a major conundrum in working with patients, where one is called upon to learn a little trick: to give advice without seeming like you are giving advice. People in distress often ask for advice, but offering that advice can be dangerous, whether you are a friend or a therapist.
Suppose an acquaintance tells you, repeatedly, about her loveless marriage to a husband who ignores her and refuses to go to marital counseling. She asks you what to do. You might think this is a no-brainer: She should leave him and find happiness somewhere else, with someone else, because she clearly isn't going to find it in her current situation.
If you tell her she should leave her husband, it is possible that she will take your advice, make a new start, and live happily ever after. But it is also possible, and perhaps even more likely, that one of these other scenarios will play out:
•She may put off making a decision, offering excuses (she can't afford it, it would traumatize her family, her husband can't live without her) but never flat-out rejecting your advice. Eventually you might grow frustrated with her complaining, or she might start to avoid you and your lectures.
•Or, she might take your advice, leave her husband and, unless she lands quickly on her feet, then have times of loneliness, guilt, regret, and poverty, and will ultimately come to believe that her troubles are your fault because you told her to do something that proved to be so painful.
So giving advice is not risk free. Perhaps the best response in a case like this is to say, like the doctor in the cartoon, something like, "Why don't you get a divorce?" or, more tactfully, "What keeps you from leaving your husband?" With these words, you're not telling her what she should do; on the contrary, you are placing the decision firmly back on her shoulders, where it belongs.
Sometimes, of course, giving advice is the right thing to do, and the essence of wisdom is to know when this is the case.
But if you've ever seen a therapist (either in real life or in the movies) make one of those maddeningly indirect replies to a request for advice, keep in mind that often no advice is the best advice.
Dec 30, 2010
I begin with a dark bit of humor: a cartoon cliché, with a man lying on a psychiatrist's couch. The man says, "All my friends think I'm crazy." The psychiatrist replies, "Why don't you kill them?"
Why is this funny? To me it's funny because it gets to a major conundrum in working with patients, where one is called upon to learn a little trick: to give advice without seeming like you are giving advice. People in distress often ask for advice, but offering that advice can be dangerous, whether you are a friend or a therapist.
Suppose an acquaintance tells you, repeatedly, about her loveless marriage to a husband who ignores her and refuses to go to marital counseling. She asks you what to do. You might think this is a no-brainer: She should leave him and find happiness somewhere else, with someone else, because she clearly isn't going to find it in her current situation.
If you tell her she should leave her husband, it is possible that she will take your advice, make a new start, and live happily ever after. But it is also possible, and perhaps even more likely, that one of these other scenarios will play out:
•She may put off making a decision, offering excuses (she can't afford it, it would traumatize her family, her husband can't live without her) but never flat-out rejecting your advice. Eventually you might grow frustrated with her complaining, or she might start to avoid you and your lectures.
•Or, she might take your advice, leave her husband and, unless she lands quickly on her feet, then have times of loneliness, guilt, regret, and poverty, and will ultimately come to believe that her troubles are your fault because you told her to do something that proved to be so painful.
So giving advice is not risk free. Perhaps the best response in a case like this is to say, like the doctor in the cartoon, something like, "Why don't you get a divorce?" or, more tactfully, "What keeps you from leaving your husband?" With these words, you're not telling her what she should do; on the contrary, you are placing the decision firmly back on her shoulders, where it belongs.
Sometimes, of course, giving advice is the right thing to do, and the essence of wisdom is to know when this is the case.
But if you've ever seen a therapist (either in real life or in the movies) make one of those maddeningly indirect replies to a request for advice, keep in mind that often no advice is the best advice.