Is it ethical to instil false hope in people with mental illness?

There's an ethical consensus in medicine that it's wrong to give patients with physical illness false hope. But what about patients with mental health problems? Might the provision of unrealistic optimism be a vital part of their treatment? Or might this serve only to prolong their suffering? Psychiatrist Justine Dembo at the Sunnybrook Health Sciences Centre has explored these delicate issues in a thought-provoking essay. Dembo highlights research showing the numerous positive illusions to which most psychologically healthy people are prone. This includes feelings that we're better than average, that we have more control over life than we really do, and an unrealistically optimistic take on the future. Writers like Ernest Becker have observed that we need these illusions to cope with the reality of being human and the fragility of our existence. "A full apprehension of man's condition would drive him insane," he wrote. Consistent with this, there's evidence that the positive illusions most of us enjoy are absent or reversed in people diagnosed with depression and anxiety. For this reason, says Dembo, instilling hope and optimism in people with mental illness can be an important part of their recovery. A positive mindset can have behavioural consequences including greater sociability and creativity, which have knock-on benefits for a patient, leading to a virtuous circle of recovery. But what if a therapist or psychiatrist truly sees no hope for a patient? Some people wit...
Source: BPS RESEARCH DIGEST - Category: Psychiatrists and Psychologists Authors: Source Type: blogs