From drsaddam -

[kyburg]

Not long ago, one of my psychiatric residents called in distress about a patient who was demanding a different therapist. “This guy is in my office shouting at me and telling me how bad I am,” the resident said.

Sure enough, the patient in question was very hostile and demeaning in talking about this young doctor. Jabbing his finger in the air, he told me how unsympathetic my resident was and how rude the staff at the front desk had been.

“This kid doesn’t know the first thing about treating patients,” he said with derision. He clearly meant to hurt and humiliate his new doctor in front of a supervisor.

I listened for a while to his litany of complaints and found it easy to understand why people didn’t like him. “It’s no surprise to me that people aren’t nice to you if this is a sample of how you behave in the world,” I said to him.

This remark did not go over well.

“I’m basically a nice guy who has a terrible problem with anxiety,” the patient said resentfully.

No...not exactly.

A very good read - and a very pertinent piece of information. You have a mental illness, sure - but that doesn't excuse really BAD behavior. Ever.

EDIT: LOL. Link takes you through an ad click-through on being your own kid's drug pusher....

Comments

[machineplay.livejournal.com]

It's weird, but I do make some progress on my 'mood-disorders' when I make changes that affect my whole self. Thinking the best of people deliberately, sending thank-you notes, not raising my voice, not taking things personally, not swearing, being on time to appointments, cleaning my room, learning to make a sincere apology, smiling and meeting people's eyes... you wouldn't necessarily prescribe all that for PTSD/depression/anxiety, but it makes a difference. Then again, I can't take drugs, so maybe I have to think outside the box anyway? Making myself a happier, more successful, more responsible person has gotten me somewhere.

[dwinghy.livejournal.com]

Yeah, I've definitely met WAY too many people in my life who've tried to use "but I have a disease/I had a bad childhood/I never had a pony" as an excuse for their unacceptable and/or assholish behaviour. That a mean, rotten personality can exist independent of mental illness, I totally believe.
OTOH I think the doctor writing that article is copping out, a bit. He mentions the guy described above obviously has anger management problems-- as a therapist isn't it his job to teach people like that how to, er, manage their anger? It's very, very true that medication doesn't necessarily help a problem like this but IF the guy is willing to try (and that is admittedly a big IF) therapy actually COULD, conceivably, turn him into less of a rageaholic asswipe (not with medication but through therapy sessions). Allowing Mr. Rageholic to write it off, either by saying "I have a problem with anxiety" or "I'm just a mean-spirited asshole" seems like a cop-out for both therapist and patient.
Eh. I'm no expert. Christ knows getting someone like that to change their stripes is usually an exercise in frustration, anyway.

[anahata56.livejournal.com]

I remember having this happen to me, working with a broker outside our office. He was the most obnoxious individual I had come across in a long time--insulting, hostile, screaming, rude, misogynistic (there isn't a woman in our office who will take his abuse anymore--he gets to work with men only now, his rep is so bad). And I told someone about what an unpleasant experience I had had with him and they said, "Oh, well, you know, he's bipolar..."

Like this was supposed to excuse it. Like this was supposed to take the sting out of the way he had treated me and make everything all better....

No--they have medicine for bipolar.

They don't have medicine for mean.

[riverheart.livejournal.com]

Ha! I have a few chronic diseases and they don't excuse me from a thing (nevermind that mine are all physical, not mental). They don't excuse me taking things out on those around me; they don't excuse me taking things out on my dear husband, even though I have been known to do this sometimes when I've been in pain for a long time (like, say, a year). I am very lucky in that he is patient and kind, but it still doesn't excuse a thing.

The patient above is basically a jerk using a disease as a shield from which he thinks he can act like a jerk.

No excuse.

[moropus.livejournal.com]

I've been on antidepressants for years. I also take something for panic attacks. I have had group and single patient therapy. Lots of it. Tons of it. I've met a lot of people who are anywhere from slightly to totally off their rockers. Me, I vary on the scale for no apparent reason.

If he can't control his behavior, no matter what they put him on, he doesn't need to be running free.

[foogod.livejournal.com]

I think one of the problems is that people tend to confuse "explanation" with "excuse". The two are not the same thing. There are lots of explanations for bad behavior, including mental illness, but that doesn't mean that any of them necessarily excuse that bad behavior.

But likewise, just because behavior is inexcusable does not mean it shouldn't be addressed just the same. I agree with dwinghy about copping out. This "doctor" seems to be of the opinion that psychiatry is apparently only about what you can fix with drugs, and everything else is somebody else's problem.

I find it interesting that he says, right out: "Of course, everyone has personality traits, but when they cause major problems in relationships and work, they cross the line into disorder. On the other hand, maybe he was mean by nature..."

Disorders are something that need to be treated, yes? That's what doctors are supposed to do, isn't it? But doctors apparently shouldn't attempt to treat disorders that are "natural"? Is that the point of this little essay? By that logic we should stop trying to address genetic disorders and birth defects too.

It sounds an awful lot to me like this patient has an anger-related personality disorder on top of his obsessive-compulsive disorder, and it's interfering with his life too, and needs to be addressed, not just written off. Unfortunately, he seems to have gotten a doctor who's saying basically "if I don't have a drug for it, then it's not an illness", and shoving him out the door for the rest of society to try to deal with instead...