The Therapeutic Alliance

In my testing and therapy, I am constantly struck by how much we don't know. How different is Bipolar II from Bipolar I? How different is Aspergers from Autism? Does depression permanently damage the brain, or are brain cells regenerated (as they are sometimes in the hippocampus)? And on and on. We know so much and so little. There is so much depression research appearing that a person could spend all of their time just reading it. But the big questions often elude us. And our patients must patiently suffer through our lack of awareness. It is as if we are always in the dark ages. Future generations will look back and marvel at how little we know, just as we look back and marvel at the treatments used in Freud's Vienna (and those were better than what was being used in the rest of the world!). It is my goal to use the best of current knowledge. What isn't known has to be imagined. We have to connect the dots and extrapolate in between for the benefit of our patients. And we have to learn from our patients. They teach us. The most exciting situation is when the partnership (AKA "therapeutic alliance") actually forms, and the patient and I go on a voyage of discovery together. We put together what we know, and something very important happens. It is an exciting experience.