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Abstract

第116巻第9号

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The Importance of the Wisdom of Not Knowing in Clinical Practice
Joichiro SHIRAHASE
Department of Neuropsychiatry, Keio University School of Medicine
Psychiatria et Neurologia Japonica 116: 758-763, 2014

 The theme of this Special issue is to investigate the relationship between pharmacotherapy and therapeutic relationships. In my paper, I first examine therapeutic relationships from a number of psychoanalytic perspectives. Specifically, I use concepts such as the building of therapeutic alliances, ego support, as well as autogenous and iatrogenous illnesses. A therapeutic relationship is a process in which a patient and his/her therapist build a relationship as collaborative therapists in the context of repeated interactions with each other. In this sense, a therapeutic relationship is not the premise for treatment, but its result. From the perspective of adherence and therapeutic effects, pharmacotherapy becomes a yardstick for measuring the quality of the therapeutic relationship. At the same time, pharmacotherapy is also a medium for building a therapeutic relationship. Lastly, I note that psychiatric knowledge and experience are factors that may impede these interactions. It is the wisdom of not knowing that helps a therapist avoid this pitfall and make therapeutic practice fruitful.
 <Author's abstract>

Keywords:therapeutic relationship, pharmacotherapy, therapeutic alliance, ego support, autogenous illness and iatrogenous illness>
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