Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘New Media and Psychotherapy’ Category

The Psychotherapy Image

Posted by Dr. Vollmer on December 6, 2012

Lori Gottlieb, the author of this NYTimes article talks about her experience transitioning from a journalist to a psychotherapist. She explains that “empty hours” are best met with marketing one’s practice to a specific need, as opposed to remaining generally interested in the internal psychic world. Have we arrived to a world where therapists need publicists? I wonder. Do we need to search for niche markets? I also wonder. This is a stimulating article which poses the question of supply and demand. Is there a demand for insight-oriented psychotherapy, or is the demand for a relatively quick-fix to a very specific problem? Does marketing one’s practice create a harvest from which to pick out more long-term patients? Does the publicity serve to overcome the inhibitions of psychotherapy, such that once the patient gets comfortable, a deeper experience can be had? In other words, does the promise of seeing a “specialist” give the patient permission to unleash one’s fantasy world? As usual, I have no answers, but only ideas and possibilities. As Ms. Gottlieb states, as our antidepressants go generic, there is much less direct to consumer advertising for medication, which may mean that there are less patients seeking mental health assistance. This, combined, with a variety of both licensed and unlicensed professionals seeking to help people guide their way through the messiness of adult life. The patient, suffering from ill-defined issues, is at a loss as to where to turn. The media, friends, relatives, and their primary care physicians, serve as referrals. The patient in pain trusts their referral source and then they land in an office, of which they do not know what will happen next. They could end up on medication, engage in long-term psychotherapy, engage in short-term behavioral techniques, or a combination of the above. There is no good algorithm. I am glad Lori Gottlieb brought this issue to her readers. I am left stimulated and confused.

Posted in Media Coverage, New Media and Psychotherapy, Office Management, Office Practice, Psychotherapy | 5 Comments »

Facebook Friending My Patients: Good Idea or Unethical?

Posted by Dr. Vollmer on September 16, 2010

     Tom,, says “I would hate for you to be my Facebook friend. You would not approve of what I have up there.” Howard, the father of a five-year old patient, asked to be my Facebook friend. Tracy,, wanted me to join her Facebook group so that I could have a deeper understanding of her art. Jessica,, wanted me to follow her on twitter. She also wanted to follow me.

    What are the rules of the road here? Is connecting with my patients through social media a boundary violation? Or, is it a tool to help me understand the world my patients travel in? Maybe it makes sense for me to be Facebook friends with parents of my child patients, since I am not directly treating them? Maybe not. Is this a case by case basis-a clinical judgment? Is this going to be yet another generational issue? An issue similar to using psychotropic medications to treat problems of daily living where many of those trained before the 80s feel that psychotropics are over-prescribed, whereas more recently trained colleagues accept the wide use of psychotropics as the norm. My older colleagues shutter at the thought of the transparency inherent in social media. Patients will no longer be able to project their ideas on to a blank screen, resulting in greater inhibitions in psychotherapy. My younger colleagues accept the new reality of our lives; social media means we lose privacy but gain connection. It is a net positive. My generation is caught in the middle; both sides make good points.

     I tilt towards accepting our new media as an opportunity for exploring new boundaries in psychotherapy. This is a new frontier for my field-an opportunity to open discussions about the psychotherapeutic frame. Is this a rigid frame or a shifting frame? Maybe after a certain time period, being Facebook friends makes sense, but if it happens too soon in the psychotherapeutic relationships, then there could be painful misunderstandings. On the other hand, painful misunderstandings are the grist for that therapeutic mill. We, my colleagues and I, need to explore the meanings of this new technological world. We adapt or we die-that makes sense to me. How we adapt is the question. I welcome your answers.

Posted in Musings, New Media and Psychotherapy | 25 Comments »

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