Monday, August 18, 2008

Psychiatrists in August....

(ClinkShrink note: I'm posting this on behalf of our missing-in-action co-blogger, Dinah. Here's hoping she gets back quickly.)

It's been a bit quieter than usual here on Shrink Rap.

Oh, it's August, the month when psychiatrists traditionally go on vacation. If we were Manhattan psychoanalysts, then perhaps we'd all be in Wellfleet, sitting on the beach, talking about our unresolved complexes, or whatever. But we're not Manhattan psychoanalysts. We're Shrink Rappers.

Funny thing, though. We've all gone on vacation in August. This is for Phoebe who commented that we all suddenly disappeared.

Roy went to Acadia in Maine. ClinkShrink went to Acadia in Maine. Funny, she deemed this completely coincidental, but it's Roy's second year in a row and he sent back such beautiful photographs (--the guy has talent) from last year that I believe they tweaked at something deep inside of Clink and she, too, just had to be there. See, I could be a psychoanalyst. Of course, you can see Roy's vacation photos, including his flat tire on Day #1 [Roy: I took them down as they were meant to be temporary and not enduring psychiatric reading], or read about ClinkShrink's life-threatening mountain climbing, on posts from earlier this month right here on Shrink Rap.

I'm still on vacation. Actually, I live for vacation. I'm in sunny, gorgeous, Southern California, soaking in the sun, eating great food, getting a fair amount of exercise (sailing, biking, walking, jogging, visiting the gym, sightseeing). I'm pleased to report that we've done nothing to endanger our lives here.

So why do psychiatrists go on vacation in August? I want to venture a guess that psychiatrists vacation in August for the same reasons everyone else does. Personally, it's not my favorite time to be gone-- I like working when there's no traffic, fewer patients (they all go on vacation, too) and I'm not crazy about the heat (hence, Southern California). August, because the younger teen is back from camp and school hasn't started yet. When my kids are grown, I have every intention of vacationing in September, when the crowds are gone and the prices are cheaper.

It seems to me that in many professions, the world slows in August and December. It's a pace I prefer, and I often wonder why we can't just pretend that it's always August.

I found only one 1964 study looking at day hospital patients' reactions to August vacations.  Half felt better after the day hospital closed for a month for vacations and half felt worse.


Anonymous said...

How true... I just returned from a vacation in So Cal this past Sunday. Hope you are enjoying your vacation! I'm looking forward to the next installment in iTunes when you are all returned and refreshed.

Anonymous said...

Actually, I'd like a real explanation as to why shrinks go on vacation in August. And also if anyone ever did a study on psych hospitalizations or some other mental health endpoint during August.

Rach said...

Who takes care of all the people who go down the tubes when their shrinks go on vacation in august? And who takes care of the shrinks who take care of the patients of the shrinks who go on vacation in august?

NeoNurseChic said...

Interesting... My psychiatrist is away from this Friday through all of next week. He didn't actually give me a back-up name in the event of a problem this time... (Well, since he has been at this office, he has actually never provided me with a back-up name when he has been away....)

I actually do not know if he is going on vacation or if he is away for work-related activities. Used to be I noticed he went away every October or November. I know last year, he did disappear for a few weeks (of undefined time), and I was wondering if his wife had a baby. It is interesting to note that with a female psychiatrist, it is pretty hard to hide that you're pregnant - but if you are a male psychiatrist, there is nothing to give way that you are about to become a father. His office pretty much represents that "blank slate" look - other than a few textbooks, journals, and his diplomas - he has no personal items that I have seen.

And in his new office, I sit across a desk from him. I don't really like that very much, come to think of it. It is less of a "working together" feel and more of is the word I am looking for? I can't think of it. But something that indicates he is the one with the power or the ultimate say or something like that.

Anyway - I digress. All I was initially going to say was that he is away this month, too. I even asked for another appointment this week before he left, hoping for today or Thursday afternoon - which are not his usual appointment days, but he has seen me at those times when I can't come in on his regular appointment days due to work. But no - so it is actually like he is gone for a lot longer than he is.

Oh well - I survived 3 months without him earlier this year - it taught me that the time apart is not as scary as I once would have thought. Unfortunately served to encourage my family and boyfriend that if I can survive those 3 months fine, then I don't need to be in therapy at all. Unintended side effect of that separation, I'm sure... It's been a long time since I have talked about my psychiatrist here, I think!

Enjoy your vacation. I loved Santa Monica when I was there several years ago.

Take care,
Carrie :)

Anonymous said...

As a psychiatrist who enjoys Shrink Rap, I have used this slow August to...start a new psychiatry blog (to supplement this esteemed one of course).

According to blog netiquette what is the most appropriate way to get noticed? If anyone feels an urgent need for an additional psychiatry blog to browse, it is at Try it--you might like it.


Anonymous said...

As a patient, I frequently remind myself that for me this is my *life*, but to my psychiatrist, it is just his *job*.

He is Jewish so I keep tabs on when their holidays are so I am prepared for an absence. He is out of the office quite a bit (he's also a prof), but I can usually get an appointment as soon as I need one.


Anonymous said...

Sorry for the double comment but I have a question: Do you guys *not* know how much you mean to us?

Am I the only one for whom their psychiatrist is important in their *daily* existence (in my head)? Or who feels *needy* when it comes to their shrnk being there for an emergency, serious med question, etc.?

If you know how much you mean to us do you:

a) not mention it/ignore it on purpose because acknowledging it would be against some tenet

b) know it but don't care

c) Don't really know it or need to hear it


Midwife with a Knife said...

Lily: I'm not a psychiatrist, but I'm going to take a whack at your question from the perspective of a doc of a different specialty.

I know that it's important to some of my patients that they get delivered by the same doc they got their prenatal care with. I know that many of them are scared, and some of them are very alone. Yet I still have to let the doc on call do their deliveries so I can go home or go on vacation. And when I do that, I tell myself, "oh, so-and-so will be ok, she won't go into labor or she'll get good care if she does." because I have to remind myself that even though I may be important in their lives, nobody is indispensible, and that if I don't go home, if I don't go on a vacation, then I ultimately won't be in a good place to provide them with good care.

And I'm sure you value your psychiatrist, but it isn't good for anybody to chronically feel that the lives of specific people (with the exception of their children) depend on them, talk themselves into never going away, etc.

I know you're not saying that your shrink shouldn't go away, I'm just saying that as a doc, I have to convince myself that it is ok to go away, because everybody has to go home, eventually.

Catherine said...

My family and I pulled out What about Bob? last night and when the psychiatrist said that he'd see Bob after Labor Day, I immediately thought of you all =)

Roy said...

MSAE: I think it's like Dinah said... since so many people vacation in August, that is the month that most of one's patients will be away. So, if you have to be away for, say, 2 weeks, might as well do it when fewer pts will be affected.

Also, from a business viewpoint, if half of your "customers" will be canceling their appts in a given time period, then you are making less money at that time, so might as well vacation. It's probably the same reason why many shop owners are closed on Sundays.

arspsychiatrica: welcome aboard! I'll have to check out your blog. I recommend frequenting other psych blogs, posting appropriate thoughtful comments (not just "hey look at me, check out my blog"), and have your name link to your blog (so, use the "Name/URL" option in Comments using Blogger). Just truly become part of the "community", and if people like what you have to say, they will check you out. Also, post regularly, NOT sporadically like we've been doing lately. I'm sure our traffic has nose-dived in August.

Lily: do we know? Of course we do (most do/should). I liked Midwife's reply...excellent explanation. But, docs need to have someone in place to handle calls while they are away. AND they need to let pts know about it. AND they need to talk to their patients starting a couple months in advance about the time off, and help their pts talk about their feelings of abandonment, rejection, etc, that comes up, how it relates to the pt-therapist relationship and also how it brings up similar past feelings from other important relationships, typically parental, spousal, or filial.

So, I have another busy week ahead, then should start posting again. I have 2 podcasts from June/July to put out and am hoping to get a fresh one recorded next weekend... if all three of us happen to be in the same city at the same time.

Check out the links I have added to the bottom of Dinah's post for interesting Shrinkless August tidbits.

Anonymous said...

"one analyst reports that over the years three of his patients unexpectedly became pregnant in August ans said I am the fantasy father of all three" He sounds like a nutter to me. The fantasy father of all three what? Patients, babies? I unexepectedly became pregant during the course of therapy. So did the therapist! Not in August. Not in the same year, not by the same guy.Accidents happen, real ones and accidents on purpose. Whoa that guy thinks he is god ot has a bad case of counterT. Old articles dude.

Dinah said...

I don't get the sense that most of my patients get terribly distressed by my vacations-- a couple get a bit anxious, but everyone is different and I don't assume that people feel fragile without me unless they express such a concern. A few people who've been abandoned by psychiatrists (abandoned: psychiatrist made permanent move out-of-state) need some reassurance- Just a vacation, I'll be back. If people ask where I'm going (most don't), I tell them.

It feels a bit uncomfortable, maybe even scary, to me to feel so needed that I have to feel guilty going on a trip. I'm just another human being, and while it's nice to be wanted and appreciated, to feel very very needed makes me a bit uncomfortable. Probably it's own post. And maybe my patients sense this and don't express a suffocating need, or perhaps my wish for a bit of freedom is such that I don't attract an overly dependent population of patients.

Yes, I tell people as soon as I know, and yes, there is coverage. And rarely does my coverage get called (ah, they wait for my return for most things!). But I often do take off, or switch my schedule around with only a little notice.

So, Roy: you plan your vacations MONTHS in advance? Give me a break.

And to whoever wanted the "real" reason that shrinks vacation in August: there is none. Most psychiatrists are parents, schools and camps function to be closed in August. Life is quieter. Summer activities (camping, sailing) can't be done in the Northeast/MidAtlantic during the winter months, and many people have issues around the academic/medical calendar that dictates that new residents and often jobs, start on July 1st. Sometimes people are settling into new jobs, or are getting new residents and employees settled, so that it may not make sense to go away in July.

It's good to be back. It was wonderful to get away. I feel like a new person.

Anonymous said...

Thanks MWAK and Roy for your comments.

I have had a couple of experiences of loss of a mental health professional. First, my therapist abruptly announced he was quitting. Then I knew that the doc I was seeing (a resident) at the university I was attending would be gone at the end of June. I freaked out completely. I knew it was coming, but losing both within months of each other? Devastating.

It turned out that the therapist renegotiated his contract and stayed, but, over a year later, I freak out.

Dr. Psychiatrist is 64!!! I am so afraid of him retiring or dying!

We've touched on this a little. I seem to get worse and worse, more and more clingy. A couple of sessions ago, he told me when he was going to be gone. I tried to play it cool so I didn't write it down or anything. I rarely call, too.


Anonymous said...

Sorry, thanks to Dinah too, for her comments.

Anonymous said...

Though most of you would probably immediately declaim with the disdain of a showdog any alleged allegiance to the seemingly outdated ideas of Freud, you nonetheless continue to honor the founder of that muchdemonized discipline, psychoanalysis, by maintaining the precedent he set by vacationing annually during the month of August. The tradition of vacationing in August is a tacit homage to the legacy of Freud. Perhaps, noting this fact, we can take this opportunity to recognize his considerable contribution to the understanding of mental illness.

Anonymous said...

Below, for example, I have attached a link to an article published this month (seemingly in recognition of Freud's seminal influence on establishing August as mental health professionals' vacation month) which provides an overview of Freud's (and those of other psychoanalysts, such as Winnicott) contributions to Modern Psychiatry.

Anonymous said...

All August vacations are due to Freud? Interesting, it's like a Horoscope. If you go in August you are Freudian, September is for Skinnerians, and July is for Jungians. Guess I'm a Freudian secretary as I just got back. Hey, my PCP is a Freudian, too!

Umm, could it have more to do with the weather being hot or with fact that many of the rest of us go away in August? Naw,

Ramalan Hari Ini said...

I have had a couple of experiences of loss of a mental health professional. First, my therapist abruptly announced he was quitting. Then I knew that the doc I was seeing (a resident) at the university I was attending would be gone at the end of June. I freaked out completely. I knew it was coming, but losing both within months of each other? Devastating.

It turned out that the therapist renegotiated his contract and stayed, but, over a year later, I freak out....!!!