The sun had not yet risen. The sea was indistinguishable from the sky, except that the sea was slightly creased as if a cloth had wrinkles in it. Gradually as the sky whitened a dark line lay on the horizon dividing the sea from the sky and the grey cloth became barred with thick strokes moving, one after another, beneath the surface, following each other, pursuing each other, perpetually. As they neared the shore each bar rose, heaped itself, broke and swept a thin veil of white water across the sand.
Posted on February 24, by Scott Alexander Attitude 1 says that patients know what they want but not necessarily how to get it, and psychiatrists are there to advise them.
This is nice and straightforward and tends to make patients very happy. Attitude 2 says that people are complicated. This is not straightforward and requires some justification, so let me give a few cases where Attitude 2 seems to me obviously correct.
A mother brings her 6 year old son to the doctor, complaining that he gets nauseous every morning. She wants the doctor to prescribe an anti-nausea pill. The doctor probes further and finds the kid only gets nauseous on school days. In fact, he only gets nauseous on school days when he has a particular gym class.
The doctor asks the kid if there are any problems in that gym class, and the kid is reluctant to say anything. After a while, he finally admits there is a bully in that class.
The mother calls the school, and the school takes care of the bully. After that the kid is no longer nauseous in the mornings. A woman goes to a plastic surgeon asking him to fix her nose, which she insists is hideously deformed. The plastic surgeon thinks the nose looks perfectly normal and asks her to be cleared by a psychiatrist before surgery.
The psychiatrist diagnoses the woman with body dysmorphic disorder, a delusional belief that one of their body parts is unbearably ugly.
He suggests she get psychotherapy instead. After several years of psychotherapy, the woman learns not to worry so much about her nose. A woman goes to her doctor asking him how to taper off her birth control pills. The doctor is surprised at this request because he knows she is planning to break up with her boyfriend.
The woman says that this is true, but she wants a child as a way to remember the relationship.
The doctor refers her to therapy for her anxiety, and she is able to sort through her conflicting feelings about leaving her boyfriend. She chooses to stay on her birth control. The doctor recommends therapy for OCD.
The doctor knows him well, and remembers that he has been admitted five times in the past six months, each time after a life crisis, and that the patient has never actually attempted suicide and never even planned how he might do it.
The doctor suggests that the man is using the psych hospital as an emotional crutch, and that instead of threatening suicide and going to the hospital whenever he is upset, he needs to learn more adaptive coping mechanisms.
Attitude 1 would have been the wrong choice in these five situations. If the surgeon had just given the woman the nose job she wanted, she would have been dissatisfied with the surgery and wanted it changed again.
If the third doctor had just told the woman how to get off birth control like she wanted, she might have had a baby for the wrong reasons and regretted it later, leading to heartache all around. If the fourth doctor had just given the man an antipsychotic, he would have unnecessarily exposed him to a potentially life-long course of very strong medication.
If the fifth doctor had admitted the man to the hospital, he would be using up scarce resources and discouraging the man from learning better coping strategies. Any halfway decent psychiatrist uses both attitudes at different times, but most people I know tend to lean to one side or the other.
The 2-leaning doctors stereotype the 1-leaning doctors as simple-minded and gullible. The 1-leaning doctors stereotype the 2-leaning doctors as antirational paranoiacs with sledgehammers.
I remember a textbook talking about a case study by a famous psychiatrist. The patient had come in talking about how her husband was being borderline-emotionally-abusive to her.
The psychiatrist interrupted her and said that she was perpetuating this dynamic to feed her own narcissism. The psychiatrist said she would never be able to get over her provoking-her-husband problem until she admitted the depth of her narcissism.
The patient refused to keep seeing the psychiatrist after that, and the psychiatrist commented that it had been a hopeless case from the beginning — the extent of her narcissism was so great that she would never acknowledge that somebody else might know more than she did.Study Flashcards On Practice Questions CNA State exam at benjaminpohle.com Quickly memorize the terms, phrases and much more.
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Take the potatoes and one by one peel all of the skin off with the peeler into the bowl with the bag. Make sure to cut out any indentions with peel on them, also cut way any brown spots on the potato.
In this case study I will be looking at how osmosis affects a potato chip. My aim is too investigate the effect of varying concentrations of certain salt solutions, and water, on the amount of osmotic activity between the solution and a potato chip of a given size and mass.
THE WAVES by Virginia Woolf The sun had not yet risen.
The sea was indistinguishable from the sky, except that the sea was slightly creased as if a cloth had wrinkles in it.
Potato is considered to be an indigenous crop of South America. In India its cultivation started in the 17th century and soon it became a main vegetable crop of the country.
Potato is a temperate crop and hence it is grown in winter season (sowing between Septembers to December and harvesting.