Their powerful need for independence having prevented them from asking for help sooner, all of the gifted individuals referred to me were in crisis: their work, school life, relationships, and physical health were in disarray. Many had developed serious forms of depression and anxiety. Some felt they were headed for hospitalization.
Once they accepted their need for help, each patient was receptive to and grateful for a hands-on, take-charge approach. Frequent, flexible, and intense sessions, as well as direct and decisive interventions, were essential in the early stages of building a firm therapeutic alliance. At times, I needed to be available by telephone, at night or during weekends. Turbulent, chaotic, and disastrous as it sometimes was, a full-blown gifted crisis could be transformed into an opportunity for growth.
An Accurate Diagnosis of Psychological Symptoms
My earliest diagnostic task was to distinguish between the symptoms of a gifted person in crisis from one with a true psychiatric or personality disorder. Common misdiagnoses are depressive, bipolar, obsessive compulsive, generalized anxiety, panic, narcissistic and borderline personality disorders (American Psychiatric Association, 1994).
The Use of Psychotropic Medication
Once I understood each patient’s symptom profile, I could, when necessary, prescribe appropriate medication. This helped them achieve rapid psychological control so that they could quickly return to work or school. Feeling more emotionally stable also helped my gifted patients take better care of their physical health and personal hygiene and improve their interpersonal relationships. Once a solid therapeutic alliance was established, medication frequently could be reduced and then eliminated.
During the initial phase of crisis management, it was important for me to suggest techniques to help eliminate substance abuse and self-destructive behavior. Providing guidelines for healthy nutrition, better sleep habits, and sensible work or study schedules were also important.