Cases reported "Iatrogenic Disease"

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1/3. Medically induced drug addiction.

    Iatrogenic, or medically induced, drug addiction is a problem affecting both patients and physicians. We describe the function of a new center devoted solely to managing iatrogenic addiction. The center accepts patients on physician referral only. The addiction usually arises as a complication of a medical disorder that is accompanied by pain and requires comprehensive and multidisciplinary evaluation and treatment. Detoxification from the offending medication, provision of chronic analgesia, and maintenance are managed with methadone. All appropriate modalities of treatment including psychotherapy, physical therapy, and relaxation techniques are employed.
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ranking = 1
keywords = psychotherapy
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2/3. Iatrogenic symptoms associated with a therapy cult: examination of an extinct "new psychotherapy" with respect to psychiatric deterioration and "brainwashing".

    In 1982, the first and only discussion of psychotherapy cults appeared in the literature. Temerlin and Temerlin (1982) studied five "bizarre" groups which were formed when five practitioners of psychotherapy simultaneously served as friends, lovers, relatives, employers, colleagues, and teachers, all to patients who were themselves mental health professionals. In choosing the term "psychotherapy cult," the authors have noted similarities of the groups they reviewed to some religious cults, citing the three definitions of the "cult" in Webster's 1966 Third New International dictionary: (1) a system for the cure of disease based on the dogma, tenets or principles set forth by its promulgator to the exclusion of scientific experience or demonstration, (2) great or excessive dedication to some person, idea or organization, (3) a religion or mystic regarded as mysterious or unorthodox. The psychotherapy cults studied by Temerlin and Temerlin varied from 15 to 75 mental health professionals held together by their idealization of a shared therapist and the activities which they conducted jointly: workshops, seminars, courses, businesses, professional ventures, and social life. As patients became more involved in the social and personal life of their therapists, they gradually withdrew from all friends and family, becoming increasingly dependent on the therapist and their new "siblings." Upon joining the group, many patients felt a sense of being loved and belongingness. The authors described the "cognitive pathology" of idiosyncratic group jargon which served to maintain an illusion of knowledge, sophistication, and personal growth, while removing all ambivalence and uncertainty. The authors concluded that psychotherapy cult membership is an iatrogenically determined negative effect of psychotherapy. Of the former cult members they interviewed, most had perceived themselves as deteriorating or at an impasse, or had experienced disillusionment with their therapists; however, they were unable to terminate unilaterally because of a pathological symbiosis with the group. This paper focuses on a now defunct school of psychotherapy which had both much in common with these psychotherapy cults and several contrasting qualities. First, the school was officially led by a junta of psychotherapists, in a deliberate attempt to avoid any taint of a personality cult. Second, the group of patients and therapists was far larger than any referred to in the original study. Third, most patients were not mental health professionals. Fourth, liberal usage was made of many novel techniques identified with the california psychotherapy scene.
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ranking = 13
keywords = psychotherapy
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3/3. Iatrogenic addiction and its treatment.

    Iatrogenic addictions, in contrast to illicit drug addictions, are commonly maintained for years before being brought to the attention of mental health professionals. Typically, by the time treatment is sought, both the physiological addiction and its related psychological problems have encapsulated the patient's life-style. The case histories described here illustrate some of the problems which typify treatment of the iatrogenically drug-dependent patient. Psychotherapeutic strategies utilizing life review, assertion training, and didactic teaching of alternative pain relief methods are often useful. The use of methadone for brief or more extended periods is sometimes helpful as an adjunct to psychotherapy.
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ranking = 1
keywords = psychotherapy
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