Thursday, May 31, 2007

What Kind of Psychiatrist Are You?

First: More of chapter 7 is up on Double Billing. If you haven't visited lately, please do. Chapter One has been voted out and replaced, the story is moving along...

So I'm finishing up a session with a patient today and he suddenly asks, "What kind of psychiatrist are you?"

The question caught me off-guard as all sorts of things rushed through my head. Oh the usual kind of psychiatrist. The kind who writes a blog.

"What do you mean?" I asked. I wasn't sure what he was looking for.

"Like, oh you know, Freudian, that."

I rambled a bit inarticulately, still not sure what the question was. I told him where I did my residency-- if you're a local psychiatrist that means a lot and I could get plugged into a neat little stereotype. The patient is in car sales and doesn't know about ideological difference between the different programs in our fine city.

"I'm a general adult psychiatrist," I said. "I don't see kids." So there, something I'm not. I'm still left with wondering what I am. "I'm not a psychoanalyst, and I don't even know any Jungians."

Okay, I was babbling. It wasn't the first time. If you listen to our podcasts, you know that. Really, I was trying to guess at the question, what did the patient really want to know, what was the wish, the fear, the concern here? He'd only seen one other psychiatrist, and only for a few visits. I knew he didn't like her-- did he want reassurance that I was different? He knew that already, after the first appointment he'd commented about how different I was than Dr. EvilShrink. Figuring Dr. EvilShrink was his only frame of reference (and Woody Allan, of course), I babbled some more:

"Dr. EvilShrink sees patients for medications and sends them to see other professionals for therapy. I do both therapy and medication management."

Then I recalled how Patient was really not very interested in psychotherapy, or so he said. Talking was a chore and he just wanted to feel better. Not everyone has to talk, I take 'em as they come.

Patient made an appointment and left. I never did figure out what he was asking or what he wanted to know. Maybe he just wanted to hear me babble, so hopefully I obliged.

And Roy, you've inspired me to hit spellcheck. I just don't have proofreading in me. It's good I have you.