Eric Sohr, M.D.: The Difficult Patient (1996)

A guide for physicians and other health care workers in dealing with difficult patients: the manipulative, demanding, self-destructive, or hostile patient, the dependent clinger, the denier, the patient with psychosomatic illness or personality disorder, etc. 97 pgs; $11.95.

ISBN10# 0940780275
ISBN13# 9780940780279

(sample page)

TABLE OF CONTENTS

Chapter 1. PRELIMINARIES
The problem
Pertinent Experience
Book Organization
Chapter 2. WHO IS THE DIFFICULT PATIENT?
No Definition
Differences in Style and Personality
Traits of Difficult Patients
Difficult Topics
Difficult Diseases
Difficult Patient Populations
Uncertainty
Communication Problems
Psychiatric Illness
Paradigm Mismatch
Spiritual Illness
Wrapup
Chapter 3. PHYSICAN EMOTIONS
Transference and Countertransference
Hatred of Patients -- Winnicott and the Good Mother
Typing of Patients
    - dependent clinger
    - entitled demander
    - manipulative help rejecter
    - self-destructive denier
Emotions as Keys to Therapy
Wrapup
Chapter 4. PATIENT PRESENTATION
Spectrum of Disease
    - real illnesses
    - mind-body
    - somatoform disorders
    - false illness
    - the matrix of patient presentation\
    - wrapup
Chapter 5. THE ILLNESS
The Patient and His Illness
    - disease versus illness
    - offers and organization
    - the meaning of illness
    - gratification from illness
    - secondary gain
The Physician and the Illness
    - apostolic function
    - the collusion of anonymity
    - the demon of uncertaintly
    - wrapup
Chapter 6. RELATIONSHIP AND ENCOUNTER
Models of the Doctor-Patient Relationship
The History
    - schema for organizing material by sensitivity
    - nonverbal and verbal expression
    - identification of the demand
    - the patient's model
    - negotiation
Markers of Difficulty
Wrapup
Chapter 7. Strategies
Key Variables
From Key Variable to Strategy
    - physician emotions
    - M.D. emotion/behavior
    - resource problems
    - personality and style
    - patient presentation
    - situations/presentations
    - physician expectations
    - topic
    - identification of the patient request
- uncertaintly about the diagnosis
Reassurance

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