Formulation #1

A diagnosis highlights commonality between patients, while a formulation is about finding the unique story for this patient.

It begins with a good summary statement about the patient. We want to answer the question,
"Why did this patient present, with this problem, in this particular way, at this time?"

The skill to practice is including all relevant and important information, while culling extraneous information.

For example...

Grant* is a 33 year old man, never married, who lives with his parents and younger sister in Granville*, Sydney. He has presented with police, to Emergency, after an argument with his mother where he pushed her. He has not left the house for two years, because of fears about what people will say about him and because he has rituals that prolong showering to the point where he has not been able to do it for four weeks.

to be continued...

* Indicates identifiers that I have invented/changed.

Skills in Psychiatry - Formulation

I am going on a journey. I'm on my way to the place where good formulations get made. I've started reading about formulation as a skill and I'm going to get practicing. I'm just realising that there's a hole in my exam armour, that needs repairing...

I'll be writing some postcards on the way.

PS. This is what I just posted a couple of weeks ago...

Is Freud right?

Ali quotes from Alain de Botton's book, Kiss and Tell, as follows

And even Freud, who one might have expected to cherish hopes for human understanding and communication, told an interviewer at the end of his life that he really had nothing to complain about:

‘I have lived over seventy years. I had enough to eat. I enjoyed many things. Once or twice I met a human being who almost understood me. What more can I ask?’

Can we ask more of this life? I just want to say no... and yes.