Psychiatric Times Vol 27 No 5

The issue of self-disclosure in psychotherapy is one of complexity and some evolution.1-16 Most discussions about the practice refer to boundary questions because self-disclosure by the therapist to the patient is a boundary issue. Self-disclosure has, of course, a number of dimensions, including clinical, therapeutic, technical and-in some cases-legal or regulatory. Despite the rich and interesting clinical issues relating to self-disclosure (outlined in Gutheil and Brodsky1), the focus of this article is on the ethical aspects of self-disclosure.1,15,16 Of necessity, the discussion centers on the more exploratory forms of psychotherapy, such as dynamic therapy, rather than on behavioral therapies, co-counseling, substance abuse treatment, or pharmacological treatment.

Bioethicists often debate whether the rapid pace of medical science truly generates new ethical questions or whether what appear to be novel dilemmas are really ancient conflicts presented in modern terms and contexts.1 The valuable essays in this Special Report offer support for each position and, more important, provide clinical wisdom for mental health professionals struggling with ethical issues both profound and prosaic in a variety of practice settings.

My “most important achievement to date” is that I’m capable of even the simplest forms of basic cognition. I can remember, perceive, speak, feel, think, solve, and-sometimes-pay attention.

The White Ribbon is an instant classic of European cinema. Filmed in black and white and set in a rural village in northern Germany circa 1912, it may remind you of early Bergman, Buñuel, and other great European filmmakers of the black-and-white era, but it is an homage to none of them.

This is the second installment of a new series in which clinically relevant research is briefly discussed and, perhaps more important, a few tips on how to read and interpret research studies are presented. Your feedback, suggestions, and questions are eagerly solicited at rajnish.mago@jefferson.edu.

Readers who know me well will not be surprised by my citing the Tao Te Ching-but some may be taken aback by my quoting football legend, Kurt Warner, who announced his retirement recently.1 Mr Warner had some wise things to say about leaving a job under your own steam, while you are still in good health-and preferably, before you are shown the door. As I prepare to step down from the editor in chief position at Psychiatric Times in June, I believe I can honestly claim that these conditions apply to my departure. The “hail and farewell!” is intended to encompass both my leave-taking from the helm and my greetings to the incoming editor in chief-my friend and colleague, James Knoll, MD.

The overall effectiveness of electroconvulsive therapy (ECT) is well known, but its speed of action is much less talked about. Here I review what is known about the time course of action of ECT in depression.

In January of my third year of medical school while attempting to study for my medical licensing examination, I began a blog. (Any distraction from learning about the Krebs cycle was heartily welcomed!) Within a week, I had posted photos of my family members, criticized an episode of ER, and griped about my studies. A social addict, I was hooked on this self-disclosure.

In his recent David Letterman–like Top 19 list of DSM5 issues, Allen Frances1 targeted a proposed revision of the DSM-IV diagnosis of Pedophilia, and 2 proposed new diagnoses: Hypersexual Disorder (HD) and Paraphilic Coercive Disorder. He protests the inclusion of pubescent teenagers in the definition of the proposed revision of Pedophilia (including the renaming of it as Pedohebephilic Disorder) and criticizes the quality of writing of these criteria.1 As the chair of the DSM5 Work Group responsible for those draft criteria, I need to address his poorly reasoned claims.