The importance of the wisdom of not knowing in clinical practice

• Published in: Psychiatria et neurologia Japonica Vol. 116; no. 9; p. 758
• Main Author: Shirahase, Joichiro
• Format: Journal Article
• Language: Japanese
• Published: Japan 2014
• Subjects: Ego; Professional-Patient Relations; Psychotherapy
• ISSN: 0033-2658

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.