Thank you Dr. Mittelman for this followup regarding the clinical dilemma you
had previously presented:


<He said he'd like therapy
<with me since it would give him a chance to get out of the RTC once in a
<while.  I don't detect any genuine therapeutic interests on his part.  On
the
<contrary, he has strong feelings of entitlement, he sees himself as having
<gotten "shafted" by the legal system, and he shows little, if any remorse,
<for his armed robbery or other illegal and dangerous behaviors.


It seems like the basic difficulty here is the nature of this young man's
problems, which are not particularly well suited to a relational therapy.
Were he highly motivated, less sociopathic, remorseful and capable of
forming a strong alliance, the logistical and privacy issues would be
relatively surmountable. Under the circumstances it does not make any sense
to try to provide treatment for him, since in all likelihood he will subvert
it for purposes of escape or other misuse.

paul hamburg md