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.


Dr. A said...

This comment is totally irrelevant, but I'll make it anyway. When I read this post, the first thing I thought of was that geico commercial when the caveman is talking to who I thought was a psychiartist. But, when I watched it again on youtube, that wasn't the case. Anyway, it's still a funny commercial -- http://youtube.com/watch?v=zJRXKPL76Rg

ClinkShrink said...

I liked that commercial too. (I'm easing my way back into blogging by posting occasional comments. I'll be back, really I will.) Although from the poll it looks like people would really rather hear about transference than prisoners (sniff).

Gerbil said...

Gee. And I bet middle-named-Roy (not of Shrink Rap) always has empathy and never makes mistakes.

I think it's good for the popular media to portray psychiatrists as human. It's equally harmful if psychiatrists are always portrayed as terrific and ethical as if they're always portrayed as horrendously flawed and unethical.

Alison Cummins said...


While hearing about transference is probably good for me, it sets my teeth on edge and raises the hair on my neck.

I actually really *like* hearing about prisoners and I always look forward to your posts.

Anonymous said...

Harvey Roy Greenbeg, MD

P.S. We already knew you weren't perfect.

Rach said...

There's a song from my childhood (maybe yours?) "Everyone makes mistakes oh yes they do!

Your sister and your brother and your mother father too

Everyone makes mistakes oh yes they do!"

But we still love you just the same Dinah.

Jayme said...

I am having a hard time empathizing with psyciatrists being falsely portrayed in the media when psych patients are portrayed far worse, more often, and with incredibly damaging consequences. I don't see much discimination against psychiatrists because of bad media portrayals. I'd really like to see you gripe about society's lack of empathy toward psych patients intead of your own. I hope this is taken with the spirit it was intended. Thank you.

Anonymous said...

Re: Dr Melfi. The guy who has the same middle name as your co-blogger did not write that she sometimes made mistakes or failed to be empathic all the time. He wrote that her treatment was riddled with EGREGIOUS mistakes and that at times she betrayed a STARTLING lack of empathy. Never watched the show, can't say what she did or didn't do,but there are mistakes and then there are mistakes. No shrink can be empathic all the time but when it comes to a STARTLING lack, then that shrink should refer or the patient should run. Shrinks everywhere: please try to remember that this is a TV character. It is wacko to get this connected with a TV character.
As for Beautiful Mind, the ECT and other treatment depicted therein date back many years. If someone suggests that their patients watch it they might also add that disclaimer.
This other Roy guy was not writing about you, but you sure took it personally and your reaction seems way out of whack with the provocation. I'm just not getting it.

Anonymous said...

Bummer--I thought shrinks were perfect.

Anonymous said...

Speaking of character/media shrink types...I adore the criminal asian psychologist character on law and order (is it criminal intent or SVU?).

Anonymous said...

Dr Wong. SVU. At your service. i love how he comes up with instant diagnoses. I think they are computer generated.

Anonymous said...

Oh yeah, it's Dr. Arnold Roy Wong!!

Sarebear said...

Clink, maybe you could talk about transferring prisoners (hee hee!)

I find your posts to be really educational (and interesting, too!) about stuff that most people don't know about or think about; I think subjects like that NEED dedicated people like you bringing these things forward for us to learn about and stuff, even if and when it doesn't seem to be popular.

I'm passionate about bringing forward issues that many may not think about, understand, consider, and/or have stigma or misunderstanding(s) about; I feel people have a passion inside for certain subjects or issues for a reason, and that much good could or can come from following that passion and enlightening others.

Anyway. I like your posts. 8^D

I hadn't even thought about the fact that my brother who was in prison for 5 months, and most likely was diagnosed there (I know he's on Wellbutrin, but not what for, although based on his behavior and knowing him, I can guess); I hadn't even THOUGHT about the stuff you talk about before I found Shrink Rap, and I have had a family member benefit from the expertise of a professional like you, engaged in helping inmates. It was months after reading your clinkish posts where it dawned on me, OH, my brother probably saw someone, who I hope is as dedicated as Clink seems to be!

His crime was a direct result of the mental illness . . . . (not that I have to explain) . . . and not that less model citizens/inmates aren't deserving of care; we're all human beings, and physical and mental health care is a basic, human right (I wish society at large, and various countries, thought so, though)).

Anyway, with that said about all deserving care, I feel especially pangs of fear and connection regarding, "What about people who had impaired judgment from mental illness, and did wrong, and have no idea why they ended up that way, why, no matter how hard they tried, they couldn't stop or escape the repetitive and overwhelming impulses . . . . (let's say, a reckless thrill when shoplifting, or two consenting adults having sex in a shopping mall parking garage stairwell, etc.) You, Clink are THERE, when people have fallen lower than they ever thought they could, when people like this, as I'm speaking of those who think it is some flaw in them, who have not ever had a diagnosis of major mental illness, or anything, who hate themselves and don't know why they have such problems controlling themselves.

YOU are there, and can perhaps catch some of this kind of thing (or most or all, but I'm cautious in my phrasing), and really provide a point where they can begin to have some hope for the future . . . .

Such is how I imagine it, had I ever been arrested for some of the risky things I've . . . . well, followed rash and seemingly overwhelming impulses on. I've never been arrested, and hope never to be. I certainly don't plan on any further risky happenings, either. Also, my examples were fabricated, not from experience, or from my brother's, either, but imaginable ones.

Anyway. You do alot of good, for all types of prisoners I bet, but especially for those struggling desperately with mental health issues that they have no or little conception or awareness/insight of.

Thanks for doing what you do. I had voted other, for some reason which escapes me now, by my other choice (lol, "other" choice than "other", lol!) would have been your posts!

ClinkShrink said...

Thank you Alison and SareBear. I have been derelict in my blogging but I will get back to it. Truly I will.