Commentary: On regulation, wishfulness, and denial.

Restraint and seclusion are unsavory topics within a discipline that cherishes verbal interventions. As such, the principles of use are haphazardly taught by in-house clinicians or private agencies. Policy standards were published in the 1980s, but they have not been officially updated, despite the fact that an American Psychiatric Association (APA) committee met in 2003 to overhaul the standards of care. In training programs, violence is given little syllabus space, compared with the treatment of mood and thought disorders. Aggression remains a stepchild symptom, even though it is frequently encountered in clinical practice.