Friday, June 21, 2013

The Therapeutic Art of Doing No-thing

Doing nothing is different from doing no harm, that endlessly advertised professional goal for doctors. You can do a lot of things and still do no harm — and often not much good either--

Don't Do Something; Just Sit There - " . . . Doing nothing is also different from handing out placebo medications, an ethically complex activity featuring doctor as shaman. To really do nothing, all shamanic trappings must be abandoned: stethoscope, prescription pad, weighty pronouncements, the works. And yet — and this is key — doing nothing is also quite different from saying, “There’s nothing I can do for you; goodbye.” Most doctors are masters of this final nothing. But keeping a therapeutic relationship afloat without the usual tools, tricks or enticements — that is a rare achievement, and surely harder than the hardest microsurgery. . . Among more than 22 million cataloged medical articles I found exactly one that seemed likely to help. Published in The Rhode Island Journal of Medicine in 1986, “The Art of ‘Doing Nothing’ ” cannot be read online and took a week to arrive via interlibrary loan. It proved to be well worth the wait. “Physicians have been trained to expect the worst of every symptom,” wrote the author, Dr. David F. Wehlage, an Indiana psychiatrist. They “ ‘do everything’ to diagnose and treat it without regard for the destructive aspects of doing too much.” In fact, Dr. Wehlage pointed out, even such simple bromides as “take my advice and don’t worry” can be harmful, casting patients in a passive, dependent role that undermines their natural problem-solving capabilities. “The art of doing nothing is learning to help by not doing or advising,” he wrote. “The evaluation is the treatment.” . . . .(read more at link above)

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