The life-story method in psychotherapy and psychiatric education: the development of confidence

The disease concept and the life-story method are perspectives of psychiatry that have different consequences for the education and practice of house officers. The premises of the disease concept are taught in medical school, and provide a familiar basis for the explanation of certain psychiatric conditions. As the house officer sees how the disease concept is applied to such problems, he rapidly becomes confident in his abilities to diagnose and treat them. For other conditions, however, the disease concept is inappropriate, and the life-story method should be chosen. The premises of this way of understanding suffering are rarely taught in a formal manner before residency training begins, and thus, when confronted with a patient for whom psychotherapy is the treatment of choice, the fledgling psychiatrist is often bewildered. An understanding of the life-story method and its implications for the process of psychotherapy should help give confidence to the practice of beginners.