Whether it’s a husband, wife, child, psychotic, democrat, republican or terrorist, it’s often impossible to have a rational discussion with a person who is absolutely certain that his way is the right way.
As a young psychiatrist who trained during the era when Harold Searles MD and Frieda Fromm-Reichman MD were doing analysis with schizophrenics, I Â believed that logical discussion and perseverance was what a good psychiatrist should do to treat a psychotic patient. It took a few years until I reached my own conclusion that without using antipsychotic medication, my task was just about impossible. I still use all my psychotherapeutic skills to connect, build a sense of trust, and discuss the myriad of options that a patient can choose, but I also do everything possible to make sure that my patient is on the right medication.
There’s a science to dealing with neurotic and  psychotic patients, but what does one do outside of a psychiatric office? The answer is perhaps simpler than you imagined.
Have the courage to express your opinion, but don’t expect your spouse or child or friend to agree. In fact, they may do just the opposite.
A few years ago, my wife and I had a fight about something (whatever the something was, I have absolutely no recollection) and I refused to attend an event with some friends. My wife tried to reason with me and gave me some examples explaining how I was dead wrong. But, being the consummate professional, I refused to accept any of it. Finally, she shook her head in frustration, picked up her pocketbook, and left.
It took a few hours of feeling angry and self-righteous until I finally got around to examining the issue and figured out what was so bothersome. When my wife came home, I sheepishly apologized, shared my theory why I did what I did, and called our friends to apologize.
What impressed me, and still does years later, is that my wife tried her best to dissuade me from being unreasonable, but when it failed, she carried on without me and made sure to have a good time. Unreasonable people shouldn’t have to make reasonable people suffer. I was unreasonable and lost my opportunity to have a fun experience.
So what do we do about a republican or a democrat who is so myopic that he won’t examine an alternative way of looking at an issue? Easy… Accept that he has the right to his opinion, enjoy your meal together, and change the subject. Follow your own reasoning when you cast your ballot.
What do we do about a terrorist who is determined that his religion gives him the right to kill a non-believer? Don’t waste your breath trying to be reasonable. Kill him before he kills you.
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Art Smukler, MD 