It was the end of a long day in the crisis clinic, and I picked up the last chart. I ushered the patient, a middle-aged woman, into the interview room. She was well-groomed and socially appropriate, and she smiled warmly as she sat down. A good sign, I thought. She did not look like the sort of person who would need to be hospitalized, which is a time-consuming and exhausting process.

“How can I be of help today?” I asked.

“I am so glad I came here today,” she responded. “I cannot tell you how terrible my life is. Sometimes I just don’t think it’s worthwhile going on. It began 21 years ago, when my first husband—a hard-drinking bastard, a real womanizer, someone I really should never have hooked up with and I wouldn’t have if my parents hadn’t nixed every other guy they met— and I can tell you, it was no picnic growing up in Westchester, because even though the average income is half a million, they treat their kids rotten.”

A virtual torrent of information followed. For the next hour, I struggled to rein in her circumstantial and wandering stories and to get at the kernel of her complaint.

The problem with overly talkative patients is how to limit the flow of information without seeming insensitive and impatient. Cox et al. (1988), in an experimental study of interviewing techniques, found the following techniques useful for “overly expressive patients”:

In general, they found that a “brisk, highly controlling style” was helpful in limiting overly expressive patients, without alienating them.