Patients’ use and experience of medication

There are many reasons why a patient may accept or take against medication, which are important to identify and explore with the patient, if possible. For some patients, symptom relief is essential, before commencing a course of psychotherapy. others may prefer to secretly use illicit substances, in order to ‘medicate’ their unsettled mind. There is also a subgroup of patients who are particularly suspicious of all medication, its side effects, and its long-t erm effects on their overall health. Their suspiciousness can, at times, be justified, if they suffer from longterm medical conditions, which often require a variety of medications with very limited results. Some other patients may (unconsciously) prefer to hang on to their psychotic beliefs or overvalued ideas, or continue to deny the severity of their illness. Hence, they resist the use of medication, since it may signify they are more ill. other patients, particularly those suffering from chronic conditions, may resent the withholding of medication on the part of the therapist who may advise against its use in the name of maintaining a ‘pure’ psychotherapeutic relationship. Conversely, other patients view medication as an intrusion in their psychotherapeutic work. Finally, those who do take medication may secretly develop problems with compliance, whilst patients with a tendency to splitting may use medication defensively by attributing all the improvement to medication, whilst denigrating the therapist and the ensuing psychotherapeutic work.

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