{"id":1093,"date":"2015-10-25T00:23:33","date_gmt":"2015-10-25T07:23:33","guid":{"rendered":"http:\/\/blog.stevenreidbordmd.com\/?p=1093"},"modified":"2015-10-25T00:23:33","modified_gmt":"2015-10-25T07:23:33","slug":"credulity","status":"publish","type":"post","link":"http:\/\/blog.stevenreidbordmd.com\/?p=1093","title":{"rendered":"Credulity"},"content":{"rendered":"

\"therapy\"<\/a>As we grow\u00a0into adulthood, each of us\u00a0develops\u00a0a\u00a0personal comfort zone located on the continuum\u00a0between paranoia\u00a0and\u00a0gullibility. \u00a0A few of us are highly suspicious by nature, a few are unwitting dupes; most of us are in between. \u00a0Mental health professionals\u00a0are no exception, and it shows in\u00a0our work. \u00a0Is a request for tranquilizers or stimulants legitimate, or are we abetting a substance abuser? When told of horrific past abuse, do we believe every word, or do we allow for possible\u00a0exaggeration or distortion?\u00a0 Credulity and skepticism exist\u00a0in dynamic balance: too much of either impairs\u00a0clinical work.<\/p>\n

Our pride animates\u00a0these assessments. \u00a0On the one hand, we see ourselves as\u00a0sensitive\u00a0and\u00a0caring. \u00a0Empathy seems to require believing people’s stories, to be “on their side.” \u00a0On the other hand, we feel vulnerable and ashamed\u00a0when fooled\u00a0(as we sometimes are), and safer and proud of ourselves when we don’t fall for it. \u00a0Fueled by pride,\u00a0proponents defend\u00a0various points on the credulity continuum. \u00a0Some psychiatrists declare that they never prescribe tranquilizers because doing so\u00a0invites manipulation by drug-seeking patients. \u00a0Conversely, some equally proud therapists never\u00a0question the meaning of their clients’ cancellations, because doing so “lacks empathy.”<\/p>\n

Like most doctors,\u00a0I’m a critical thinker by nature. \u00a0This is a nice way of saying my comfort zone lies\u00a0slightly closer to paranoid than gullible. \u00a0The perverse logic\u00a0of the Freudian unconscious thus comes naturally to me. \u00a0Patients who claim complete marital satisfaction may be\u00a0in denial,\u00a0or at least recalling selectively. \u00a0Impassioned pronouncements of adoration may be “reaction formation,” telegraphing the exact opposite. \u00a0Dramatic\u00a0hatred or disgust may hide a fascination, even an attraction. \u00a0The trick here, lest we treat our prejudice\u00a0and not the real person in front of us, is to entertain such possibilities without becoming too attached to them. \u00a0It’s also important to distinguish empathy from blind agreement, belief, or endorsement. \u00a0I can empathize with a delusional person’s fear and panic without endorsing the delusions themselves.<\/p>\n

A funny thing happened to me the other day. \u00a0A mental health professional in a remote\u00a0land emailed\u00a0me, seeking online psychotherapy for himself. \u00a0I was flattered\u00a0that\u00a0this colleague searched the world over and chose me. \u00a0He sought exactly the type\u00a0of psychotherapy I like to conduct. \u00a0If not for distance \u2014 which would ultimately be a deal-breaker in any case, as I consider online therapy a poor substitute<\/a> for the in-person kind \u2014 it seemed almost too good to be true.\u00a0\u00a0Thus, wary of falling prey to my own pride and narcissism, I immediately suspected\u00a0a scam. \u00a0 After all, if something\u00a0looks too good to be true, it probably is. \u00a0I imagined this email went to many therapists, and that it was a con, like those Nigerian emails<\/a> that promise great riches and are\u00a0now an internet cliche. \u00a0This is precisely\u00a0what con artists do so well: appeal to one’s greed or pride. \u00a0They hook\u00a0you, then reel\u00a0you\u00a0in. \u00a0I wasn’t going to let that happen.<\/p>\n

As a savvy internet user, I knew just what to do. \u00a0I found the person online, and wrote him directly via his website. \u00a0I included the bogus email I received, to let this far-flung colleague know I wasn’t about to be taken in, and also that his identity was likely\u00a0stolen\u00a0for nefarious purposes. \u00a0I was rather\u00a0proud of myself.<\/p>\n

It turned out the original email was legitimate. \u00a0Adding injury to insult, I also violated the privacy of\u00a0my correspondent, who doesn’t read his own website email. \u00a0I had unwittingly turned an earnest request into an awkward encounter by being too incredulous and self-protective. \u00a0In rushing to defend my\u00a0pride against an imaginary threat,\u00a0that very pride distanced me from someone who sought my help, and even hurt\u00a0him. \u00a0It was an important and humbling lesson.<\/p>\n

I sometimes share with patients that there is no disproving paranoia; it’s the safer stance at\u00a0any\u00a0moment. \u00a0Why ever let your guard down? Unfortunately this safety, which is sometimes only illusory in the end, comes at significant\u00a0cost:\u00a0isolation, viewing\u00a0others as threats, constant fight-or-flight tension. \u00a0Sometimes this is the best self-protection we can muster\u00a0in the aftermath of emotional abuse or\u00a0betrayal. \u00a0However, it’s not the best we can do as human beings. \u00a0A degree of credulity, in contrast, brings vulnerability. \u00a0We can be hurt, humiliated, and diminished. \u00a0But it also allows\u00a0relatedness,\u00a0connection, and love.<\/p>\n

In order for dynamic therapy to lead to change, psychotherapists must get caught up in our\u00a0patients’ dynamics. \u00a0Not too much, such that we\u00a0lose perspective and act like everyone else in the patient’s life. \u00a0Nor too little, such that no genuine connection or relatedness occurs. \u00a0Both parties\u00a0ideally permit\u00a0themselves enough credulity to be drawn\u00a0into emotional engagement, while\u00a0maintaining enough skepticism\u00a0(or “observing ego”) to note what is happening. \u00a0Ideally, that is,\u00a0for\u00a0we therapists are\u00a0the more obliged\u00a0to maintain a watchful eye,\u00a0and must balance credulity and critical thinking more carefully.<\/p>\n

Logical argument\u00a0is\u00a0unlikely to convince the paranoid to be more credulous, nor the gullible to be more skeptical. \u00a0Our comfort zones are established early and unconsciously, based on emotion not logic. \u00a0The emotional power of dynamic psychotherapy and psychoanalysis, as well as close, healthy relationships in everyday life, can nudge\u00a0our comfort zone\u00a0in a direction that serves us better \u2014 and serves our patients better, if we happen to be psychotherapists ourselves. \u00a0Meanwhile, reflecting on prideful attachment to a particular stance on this continuum may offer\u00a0us perspective and\u00a0more\u00a0flexibility.<\/p>\n

Image courtesy of Ambro\u00a0at FreeDigitalPhotos.net<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

As we grow into adulthood, each of us develops a personal comfort zone located on the continuum between paranoia and gullibility. A few of us are highly suspicious by nature, a few are unwitting dupes; most of us are in between. Mental health professionals are no exception, and it shows in our work. Is a […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[34,8],"tags":[36,43],"class_list":["post-1093","post","type-post","status-publish","format-standard","hentry","category-human-nature","category-psychotherapy","tag-risk","tag-uncertainty","odd"],"aioseo_notices":[],"_links":{"self":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/1093","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1093"}],"version-history":[{"count":7,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/1093\/revisions"}],"predecessor-version":[{"id":1103,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/1093\/revisions\/1103"}],"wp:attachment":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1093"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1093"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1093"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}