Tuesday, September 24, 2013

Mania Case Study

"I want to be a psychiatrist, because I can read minds real good."

Note the racing thoughts and derailment after she is asked about her goals. Remember that she is not high on amphetamines. She is manic, which involves not just euphoria but psychosis -- in her case delusions. It is always striking to me how many inpatients say that they want to be (or already are) psychiatrists or psychologists.


  1. Do the grandiose delusions possibly play a role in wanting to be a psychiatrist? They think they can do your job, and do it even better?

    -Jordan Bailey

    1. For the manic patient, yes. You will see a film next week in which a patient believes himself to be God. And another who responds to a doctor's question, "How can we help you today?" with "No, it's more like, how can I help you?"

      For other patients (e.g., schizophrenics), I think the assumption of the title of psychiatrist or psychiatrist has more to do with grasping desperately at some kind of identity, because theirs has disintegrated. It's also possible that their frequent choice of "mental health professional" as job title has to do with both the availability heuristic (that's the job title of the people they are surrounded by) and positive transference (they have had some positive experiences with MHPs in the past).


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