Glen O. Gabbard, MD

A graduating resident recently told me that a psychiatric group attempting to recruit him informed him that he would have 10 minutes for medication appointments and 30 minutes for new patient evaluations. He was horrified. (So was I.)

Prevention of professional boundary violations in psychotherapy is a matter of crucial importance for the mental health field. Patients are damaged by boundary violations. Psychotherapists' careers are ended. Families of therapists and patients alike are devastated.

An expert in the topic explores the historical background that led to problems with boundary violations in psychotherapeutic practice and describes community standards for professional boundaries when practicing psychotherapy. The difference between boundary crossings and boundary violations is clarified and discussed, as are the psychological types most likely to violate those boundaries. Possibilities for rehabilitation and the format for rehabilitation are also provided.

Whenever a Stanley Kubrick film opens, it is an event. Kubrick, who is considered by many the cinematic genius of the 20th century, made 15 feature films. The eager anticipation surrounding his last film "Eyes Wide Shut," scheduled to be released this summer, has intensified even further because of Kubrick's unexpected death last March at the age of 70. Although the film is shrouded in standard Kubrickian secrecy, leaks suggest that Tom Cruise and Nicole Kidman play psychotherapists who are sexually involved with their patients.

With advances in the neurosciences, and especially in imaging techniques, we stand at the threshold of demonstrating that psychotherapy is a powerful intervention that affects the brain. While it has been intuitively obvious to most clinicians that psychotherapy must work by affecting the brain (how else could it work?), recent breakthroughs in technology demonstrate what kinds of changes occur with psychotherapy.