Tuesday, August 14, 2007

Shrinks Aren't Perfect

Oh, gosh, I got home and realized I don't have my reference. I was reading Psychiatric Times today and came across a letter to the editor. All I remember is that the writer's middle name was Roy, though not of Shrink Rap.

So apparently there was an article that said the media was getting better about their portrayals of psychiatry. The middle-named-Roy guy (not of Shrink Rap) wrote in to say that he disagreed, that medial portrayals are not getting better. He cited the movie A Beautiful Mind as being an unfavorable and inaccurate view of our profession. He noted that fictional psychiatrist Dr. Jennifer Melfi of The Sopranos is held up as a realistic TV psychiatrist but, he said, she makes mistakes and often lacks empathy.

I have a confession to make. Sometimes I make mistakes and sometimes I lack empathy. I try to be understanding. sympathetic, to bounce back a patient's emotional life in words that make them feel understood-- really this is the meat of therapy. Sometimes, people describe to me reactions that just don't resonate with me--- in the situation they are describing, I just wouldn't feel the way they feel. If it's a huge disconnect, I ask more questions, get more detail, but sometimes I just can't get on the same page. This is particularly true when people talk about having literally violent reactions to minor provocations, just to give an example. And there are times when it's clear I've simply said the wrong thing-- if it's obvious by the look on the patient's reaction, I try to address it, but sometimes people feel injured and it's not apparent until much later.

Dr. Melfi makes mistakes. At times, she lacks empathy. No wonder I like her so much.