Parasuicidality and Paradox: Breaking Through the Medical Model

by Ross D. Ellenhorn MSW, PhD

Overview

"This book describes parasuicidality from a different perspective, yet still within the framework of DBT. These concepts will be helpful to clinicians, who often spend much of their time dealing with these troubling behaviors .This book is well worth the price and the reader will not be disappointed." Score: 94, 4 stars

--Doody's;

"This book describes parasuicidality from a different perspective, yet still within the framework of DBT. These concepts will be helpful to clinicians, who often spend much of their time dealing with these troubling behaviors .This book is well worth the price and the reader will not be disappointed." Score: 94, 4 stars

--Doody's

"Ross Ellenhorn brings a fresh, new look at what has been called parasuicidality. Rather seeing it solely as a medicalized symptom of mental disorder, he incisively shows how threats of suicide emerge from the social context and can be better understood and treated within a framework of social relationships. This well documented and clearly written book is must reading for anyone interested in better understanding and dealing with parasuicidality. "

"This book deals with the issue of parasuicidality using a dialectical behavior therapy (DBT) approach, but posits that clinical interactions aid and abet that specific behavior. It presents both theoretical and pragmatic ideas of how to deal wi th patients who often pose the greatest challenge to clinicians. " Gary B Kaniuk, Psy.D. (Cermak Health Services)

--Peter Conrad, Harry Coplan Professor of Social Sciences, Brandeis University, and author of The Medicalization of Society: On the Transformation of Human Conditions into Medical Disorders

In this unique and groundbreaking book, Dr. Ellenhorn offers a very different approach to assisting parasuicidal patients with their problems, an approach that avoids medicalized interactions while enhancing authentic encounters with patients. He makes extensive use of vignettes to demonstrate various types of scenarios between clinicians and patients. A number of other effective techniques are discussed, including:


• Ways to enhance team treatment planning through a brainstorming process called "The Hourglass"


• Alternative methods of documenting treatment that serves to protect clinicians from concerns about liability


• Helping patients focus on life goals and changing themselves through clinician-patient interactions



;

Foreword by Arthur Freeman

Preface

Acknowledgments

Introduction

Part I: A Theory Of Patient Careerism


1. The Borderline Fallacies



2. The Dialectics of Failure



3. The Patient Career


PART II: The Practice of the Game


4. The Game: Treating the Problem of Treatment Seeking



5. The Attitudinal Conditions for the Game



6. Relationship



7. Clinician's Authorship



8. Motivation and Change


Part III: Organizational Considerations


9. Deinstitutionalizing Institutions



10. Conclusion: Alienation, Dehumanization, Conformity, And Their Influence on Parasuicidal Behavior


References

Index

Product Details

ISBN-13:	9780826115492
Publisher:	Springer Publishing Company
Publication date:	09/26/2007
Sold by:	Barnes & Noble
Format:	eBook
Pages:	232
Sales rank:	926,390
File size:	4 MB

Table of Contents

Foreword by Arthur Freeman
Preface
Acknowledgments
Introduction
Part I: A Theory Of Patient Careerism

1. The Borderline Fallacies


2. The Dialectics of Failure


3. The Patient Career

PART II: The Practice of the Game

4. The Game: Treating the Problem of Treatment Seeking


5. The Attitudinal Conditions for the Game


6. Relationship


7. Clinician's Authorship


8. Motivation and Change

Part III: Organizational Considerations

9. Deinstitutionalizing Institutions


10. Conclusion: Alienation, Dehumanization, Conformity, And Their Influence on Parasuicidal Behavior

References
Index

What People are Saying About This

From the Publisher

"Ellenhorn has written a compelling, multi-layered, and complex text. Its overriding strength is its erudition. Unlike other texts on 'how to treat…,' whatever the disorder may be, Ellenhorn takes the reader through the theoretical, philosophical, empirical, and clinical issues involved in the paradox of treating the parasuicidal patient within the present system. His arguments for change must engender in the reader a goal of becoming part of the change. For many of us, we have been, over the years, part of the problem."
--From the Foreword by Arthur Freeman, EdD, ABPP

"Ross Ellenhorn has written a brilliant 'social psychology of social psychology' in which he traces the phenomena of 'patient careerism' and 'parasuicidality' as inherently linked to interactions between clients and clinicians. Utilizing a range of data covering empirical social science and clinical studies, as well as existential and epistemological insights drawn from the Humanities, he successfully dismantles and exposes the futility of the contemporary medical model. In an engaging and refreshing prose, Ross Ellenhorn courageously offers a tried and successfully utilized practical solution for treating these phenomena. His is the voice of Rollo May, Erich Fromm, Erving Goffman, C. Wright Mills, and other ghosts of humanist psychology and sociology past. This is a must read for students of social psychology, sociology, and social science practitioners generally. "
--Glenn A. Goodwin, PhD, Emeritus Professor of Sociology, Pitzer College
(Adjunct) Professor of Sociology, University of La Verne

"'Oh, my God, I feel suicidal.' How many times has the great majority of us uttered those words, or overheard them from someone else? No worries, we mutter to ourselves, the phrase is only a figure of speech. Only a figure of speech: how could an act as final as suicide insinuate itself into the language as nothing more than a fleeting figure of speech? Suicide, we all recognize, stands out as a physical act, but it often makes its presence felt first as a speech act. Any speech, even a figure of speech, demands attention. So, when someone - anyone - utters those words, I want Ross Ellenhorn to be listening. He has his ears pitched differently from the rest of us: he hears in those words a plea for help, but not in the ordinary way. For some in the profession, help masquerades as just another four-letter word. Not for Ellenhorn: he goes after agency. For him, I feel suicidal reveals a person's desire for enough power to take on this vast and rugged world. It means I want to possess the fullest measure of agency - strength: of conviction, of will, of temperament. You don't have to be a professional to read this book. You just have to be willing to shake your old beliefs - about intervention, about therapy, about the medical model itself. Go ahead: It may just save your life. Or someone else's."
--Barry Sanders, PhD, Professor, History of Ideas, Pitzer College, co-author of Alienable Rights: The Exclusion of African Americans in a White Man’s Land, 1619-2000, and author of A is for Ox: The Collapse of Literacy and the Rise of Violence in an Electronic Age

Editorial Reviews

Reviewer: Gary B Kaniuk, PsyD (Cermak Health Services)
Description: This book deals with the issue of parasuicidality using a dialectical behavior therapy (DBT) approach, but posits that clinical interactions aid and abet that specific behavior. It presents both theoretical and pragmatic ideas of how to deal with patients who often pose the greatest challenge to clinicians.
Purpose: According to the author, "this book is about people who repeatedly seek help from professionals for their suicidal or self-injurious behavior." Later, the author continues: "This book is my attempt to document what I've learned about individuals who engage in parasuicidal behavior and to suggest new strategies for working with them," describing the strategies as focusing "on the nexus between individuals with particular existential needs and medical institutions that fulfill these needs."
Audience: Although it's not stated, the book seems to target mental health professionals who see patients displaying parasuicidal behaviors, and clinicians would benefit most. Graduate students in psychology and social work would also gain much from this book, especially in the context of a cognitive-behavioral theory and/or practice course. Dr. Ellenhorn has a PhD in sociology and has worked for over 20 years in the field of mental health.
Features: This book addresses both theory and practice, patients and organizations. Dr. Ellenhorn begins with two caveats: he feels psychological issues are spiritual issues as well, and he is ambivalent about Western medicine, i.e., trying to solve all problems with medication. He discusses at length "patient careerism," the psychological and social factors that help maintain the patient's help seeking over years and even decades. In an interesting chapter titled "The Game," the author defines the game as "a process with specific demarcated goals that cannot be reached by any one strategy." That chapter is followed by a wonderful explanatory figure that highlights the game in the context of a clinical vignette. He presents an interesting technique he calls the hourglass, which is useful for organizing treatment planning meetings. There is also a nice section on risk management including liability, documentation, and supervision. Vignettes are used throughout the book, which is extremely helpful for the reader.
Assessment: This book describes parasuicidality from a different perspective, yet still within the framework of DBT. These concepts will be helpful to clinicians, who often spend much of their time dealing with these troubling behaviors. The vignettes are revealing and instructional. The author doesn't want to simply abandon the medical model, but notes that not everything is solved by psychopharmacology. This book is well worth the price and the reader will not be disappointed.

Doody's Review Service