Helpful patients are not hateful patients

Therapists should encourage and support, not dread, “helpful patients”. Internet or other research by the client can indicate active involvement in treatment.

In 1978 JE Groves described four categories of “hateful” patient, ie: the patients most physicians dread:

  • dependent clingers
  • entitled demanders
  • manipulative help-rejecters
  • self destructive deniers

To this list a fifth category appears to have been added: “helpful” patients, who search the internet for details of their condition and treatment and provide these to their therapist. Comments from colleagues (in person and via blogs), as well as cartoons and the popular press, suggest that these folks inspire almost as much dread (or, at least, derision) as the other four stereotypes.

Critics argue that precious clinical time is wasted explaining to “helpful patients” the shortcomings of the information they proffer: exaggerated claims of efficacy due to poor journalism or dubious science which never reaches peer-reviewed journals.

The famous astronomer and debunker of pseudoscience Carl Sagan described a man who professed to be interested in science. He had read only of Atlantis, ghosts, alien abductions and other unproven speculations. Sagan didn’t deride the man’s gullibility. Sagan railed against the education system which hadn’t provided the sceptical tools a man of such curiosity and enthusiasm needed to separate the wheat from chaff in his reading.

Cancer patients using the Internet for information are more positive and more active participants in treatment. The curiosity and enthusiasm of “helpful patients” can be squandered by therapists who, unlike Carl Sagan, attribute any problems (eg: uncritical acceptance of findings, regardless of where or how they’re published) to the client.

If a client proffers information from books, newspapers or the net, the time taken to explain why unsuitable material is unsuitable is well spent: rather than rejecting the “helpful patient”, directing them to more reputable sources (perhaps with some hints as to how to recognise these) should maintain their enthusiasm and involvement in their treatment.

2 thoughts on “Helpful patients are not hateful patients

  1. Yay!

    Hiya Relaxed Therapist,

    De-lurker here to say thanks for this site. I run a snotty little punk rock board dedicated to psychiatric reform, because in spite of the atrocities done in the name of mental health, I believe reform is possible. I’m going to be citing and linking to your site when pertinent issues arise, this is a real healing place you got, I wanna share it; the issues you introduce and your take on them, as a practitioner, wow, just great stuff that meets a need. Thanks again and kind regards~

    Robin aka flawedplan, of

    “Our Common Condition.”

  2. I don’t know where to begin in response to this condescending blog except to say that if you have this much contempt for those you purport to help, you certainly fail to put yourself in their shoes.

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