[The importance of the wisdom of not knowing in clinical practice]

Joichiro Shirahase

Research output: Contribution to journalArticlepeer-review


The theme of this Special issue is to investigate the relationship between pharmacotherapy and therapeutic relationships. In my paper, I first examine therapeutic relationships from a number of psychoanalytic perspectives. Specifically, I use concepts such as the building of therapeutic alliances, ego support, as well as autogenous and iatrogenous illnesses. A therapeutic relationship is a process in which a patient and his/her therapist build a relationship as collaborative therapists in the context of repeated interactions with each other. In this sense, a therapeutic relationship is not the premise for treatment, but its result. From the perspective of adherence and therapeutic effects, pharmacotherapy becomes a yardstick for measuring the quality of the therapeutic relationship. At the same time, pharmacotherapy is also a medium for building a therapeutic relationship. Lastly, I note that psychiatric knowledge and experience are factors that may impede these interactions. It is the wisdom of not knowing that helps a therapist avoid this pitfall and make therapeutic practice fruitful.

Original languageEnglish
Pages (from-to)758-763
Number of pages6
JournalSeishin shinkeigaku zasshi = Psychiatria et neurologia Japonica
Issue number9
Publication statusPublished - 2014 Jan 1

ASJC Scopus subject areas

  • General Medicine


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