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Can the lack of unconditional positive regard change the correct diagnose and the decision of treatment? case report

Published online by Cambridge University Press:  16 April 2020

M.C. Sarpe
Affiliation:
Psychiatry, ‘St. Pantelimon’ Hospital, Focsani, Romania
M. Ladea
Affiliation:
III Psychiatry Ward, “Obregia” Clinical Hospital of Psychiatry, Bucharest, Romania

Abstract

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Carl Rogers, one of the founders of humanistic approach in psychology, sees people as basically good and healthy. He considers mental health as the normal progression of life, and believes that mental illness and criminality are distortions of that natural tendency.

Rogers felt that a good therapist must have three very special qualities: Congruence, Empathy and Respect -- acceptance, unconditional positive regard towards the client. These qualities are “necessary and sufficient”.

We present the case of an 18-year-old adolescent with distressing thoughts of killing someone, a colleague or a family member, and compulsions like the wish to be restrained to the bad so that he couldn’t hurt someone. He was first diagnosed with premorbid symptoms of a psychotic disorder by a psychologist, and he was recommended to begin antipsychotic treatment. We subsequently diagnosed him with obsessive-compulsive disorder due to the fact that he felt repulsion and remorse for having these thoughts. He began the treatment with selective serotonin reuptake inhibitors and Rogersian therapy.

We intend to demonstrate that the lack of acceptance and unconditional positive regard as well as communication problems with the patient can interfere with giving the correct diagnose and decision of treatment.

“If I accept the other person as something fixed, already diagnosed and classified, already shaped by his past, then I am doing my part to confirm this limited hypothesis. If I accept him as a process of becoming, then I am doing what I can to confirm or make real his potentialities”, Carl Rogers.

Type
P03-157
Copyright
Copyright © European Psychiatric Association 2011
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