What is your patient’s predicament?

Daniel D. Cowell, MD
Senior associate dean for graduate medical education, Professor of psychiatry, Department of psychiatry and behavioral medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV

When a patient’s symptoms seem disproportionate to apparent stressors, I call this presentation a patient’s predicament: a unique, profoundly unsettling, but poorly understood misgiving that something is wrong—perhaps terribly so—and that life may never be the same again. Emotional flooding typically overwhelms these patients, and they are unable to express what they are experiencing.

For mental health professionals, the concept of a predicament is useful when working with patients who are moderately to severely ill or facing a life-diminishing or life-threatening illness.

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