Deferred obedience: again, 'a deferred effect...a "deferred obedience" under the influence of repression'. Thus for instance Freud explored the different phases of a man's infantile attitude to his father: 'As long as his father was alive it showed itself in unmitigated rebelliousness and open discord, but immediately after his death it took the form of a neurosis based on abject submission and deferred obedience to him'.
I recently asked a former president of the APA how he used the DSM in his daily work. He told me his secretary had just asked him for a diagnosis on a patient he’d been seeing for a couple of months so that she could bill the insurance company. “I hadn’t really formulated it,” he told me. He consulted the DSM-IV and concluded that the patient had obsessive-compulsive disorder.
“Did it change the way you treated her?” I asked, noting that he’d worked with her for quite a while without naming what she had.
“No.”
“So what would you say was the value of the diagnosis?”
“I got paid.”
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"As the enemy closed in on Moscow the attitude of the inhabitants to their situation, far from becoming all serious-minded, actually became more frivolous, as always happens with people who can see a terrible danger bearing down on them. At the first approach of danger two voices always speak out with equal force in a man's heart: one tells him very sensibly to consider the exact extent of the danger and any means of avoiding it; the other says even more sensibly that it's too wearisome and agonizing to contemplate the danger, since it is not in a man's power to anticipate future events and avoid the general run of things, so you might as well turn away from the nastiness until it hits you, and dwell on things that are pleasant. Left to himself a man will usually listen to the first voice; out in society he listens to the second one. This is what was now happening to the good people of Moscow. It was years since there had been so much fun in the city." 11Tolstoy, Leo. War & Peace. Anthony Briggs Trans. Penguin Classics: London, 1868-9/2005.
In applying the standards of "usual, customary, and reasonable," the following guidelines are applicable: If a psychological treatment is "usual" or "customary," an inference that the treatment is also "reasonable" is warranted. If the treatment is neither "usual" nor "customary," then it shall satisfy the criterion of "reasonable."This law confuses me. I am afraid that it is a permissive statute, allowing psychologists whose practice is unreasonable a get out of jail free card. If I complain to the State Board of Psychological Examiners about my doctors' unreasonable treatment of me - like for example, when a doctor insists that I take psychiatric medication but adamantly refuses to tell me why, and then becomes abusive and insulting when I refuse to put something in my mouth against my will - then this law will let him get away with it.
45:14B-1. Short title
This act shall be known and may be cited as the "Practicing Psychology Licensing Act."
L.1966, c. 282, s. 1.
...
45:14B-31. Definitions
As used in this act:
a. "Administrative information" means a patient's name, age, sex, address, educational status, identifying number, date of onset of difficulty, date of initial consultation, dates and character of sessions (individual or group), and fees;
b. "Diagnostic information" means therapeutic characterizations which are of the types that are found in the Diagnostic and Statistical Manual of Mental Disorders (DSM III), of the American Psychiatric Association, or other professionally recognized diagnostic manual;
c. "Disclose" means to communicate any information in any form;
d. "Independent professional review committee" means that group of licensed psychologists established pursuant to section 14 of this act by the State Board of Psychological Examiners;
e. "Third-party payor" means any provider of benefits for psychological services, including but not limited to insurance carriers and employers, whether on an indemnity, reimbursement, service or prepaid basis, but excluding
governmental agencies;
f. "Usual, customary or reasonable." In applying this standard the following definitions are applicable:
(1) "Usual" means a practice in keeping with the particular psychologist's general mode of operation;
(2) "Customary" means that range of usual practices provided by psychologists of similar education, experience, and orientation within a similar geographic or socioeconomic area;
(3) "Reasonable" means that there is an acceptable probability that the patient will realize a significant benefit from the continuation of the psychological treatment.
In applying the standards of "usual, customary, and reasonable," the following guidelines are applicable: If a psychological treatment is "usual" or "customary," an inference that the treatment is also "reasonable" is warranted. If the treatment is neither "usual" nor "customary," then it shall satisfy the criterion of "reasonable."
L. 1985, c. 256, s. 1.
"If the treatment is neither "usual" nor "customary," then it shall not satisfy the criterion of "reasonable."
