Читать книгу Well-Being Therapy - G.A. Fava - Страница 22

Soon after the therapy was over, I started wondering what had actually happened. I remember one day in Albuquerque I was discussing a case with a resident in psychiatry and my mentor Robert Kellner during the weekly meeting of our psychiatric unit. A patient was not responding to treatment and I had decided to switch her from one drug to another. She had improved very much and rapidly, and I suggested a possible neurotransmitter mechanism for it. The resident had a different view in terms of receptor modifications and we started a lively discussion.

We did not notice that a nurse was trying to say something, unsuccessfully. But during a pause of our debate she said, ‘I do not know how to tell you this, docs. But the truth is that we forgot to change the medication and the patient is still taking the old one.’ I wished I could have magically disappeared from the room. I was so ashamed of myself and of our silly discussion. But Robert Kellner was, as always, very kind and supportive and explained:

This case offers a very good lesson. When a patient gets better, the most likely explanation and the one you should keep in mind is that this has nothing to do with what you did, prescribed, or said. There are many potential explanations you may not be even aware of. Only controlled studies may ascertain whether there is something therapeutic in what you are doing.

So my first reaction was: who knows what made Tom get better? Maybe it was the quality of our relationship, my stories, or something that happened to him in the course of therapy. I had found a road to recovery that was not the usual one, but I needed to test it in a scientific way.