0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
CLINICAL SYNTHESIS   |    
Ask the Expert: Exploring the Clinician's Concern About Unreported Abuse of Alcohol
Susan G. Lazar, M.D.
FOCUS 2007;5:167-169.
View Author and Article Information

CME Disclosure

Susan G. Lazar, M.D., Clinical Professor of Psychiatry Georgetown University School of Medicine, George Washington University School of Medicine, Uniformed Services University of the Health Sciences, Supervising and Training Analyst, Washington Psychoanalytic.

No conflict of interest to report.

How does a psychiatrist explore a patient's concern about unreported abuse of alcohol with a psychotherapy patient?

We clinicians often encounter this important and common problem. While it presents us with the power to intervene and help it also confronts us with the limits of our therapeutic capacities. One complicating factor may be a clinician's basic psychotherapeutic stance as a predominantly receptive listener who attends primarily to the distressing symptoms that the patient brings to our attention. This stance can be problematic with patients who abuse alcohol because they often may not report the extent of their drinking both from shame and avoidance and also because the defenses of denial and dissociation minimize the importance of the issue within their own awareness.

So, how can we become aware of an alcohol problem that may not be accurately reported by the patient? Several points are helpful to keep in mind:

Once we elicit the report of alcohol abuse, how can we intervene? It is crucially important to understand the patient's psychological history and psychodynamics as a whole with particular regard to the role that alcohol use has played within the patient's psyche. A few very typical examples include the use of alcohol a) to soothe chronic anxiety and/or low self-esteem that constrict interpersonal and social functioning, b) to ease crippling and inhibiting perfectionism, and c) to give relief with stringent restrictions and even frank prohibitions against sexuality. Some typical clinical examples and therapeutic strategies follow:

Miller WR, Rollnick S: Motivational interviewing: preparing people to change. New York, Guilford, 2002.
 
References Container
+

References

Miller WR, Rollnick S: Motivational interviewing: preparing people to change. New York, Guilford, 2002.
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Articles
Books
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 9.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 13.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 2.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 8.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 8.  >
Topic Collections
Psychiatric News
Read more at Psychiatric News >>
PubMed Articles
Prevalence of unhealthy alcohol use in hospital outpatients. Drug Alcohol Depend Published online Aug 28, 2014.;