Friday, June 05, 2009

The Psychiatrist as Writer

Victor sent a link to me from the NY Times: Therapists Wired to Write by Sarah Kershaw.

She tells about a New York City writers group composed of six psychotherapists who get together to write-- fiction, screen plays, all sorts of stuff. They've been meeting for 7 years, and like the Shrink Rappers, they sound like the group has become a source of connection and friendship. One of the group members had a Bat Mitzvah at age 67 and the others all went! Kind of nice. Kershaw writes about the group:

hey have also used the group as a safe cocoon to vet and write unpublished prose, a dissertation, writings on traumatized Iraqi war veterans and now a book on running a writing group for psychoanalysts.
The stuff of therapy is not only a lot stranger than fiction but also contains the ever-unfolding narrative of life, with its pain and pathos, feats and failures.
That is some rich material for a writer.
“Everybody comes in with their own stories, and they can be so staggeringly original,” said Bonnie Zindel, the psychoanalyst who started the writing group seven years ago. “We all need stories to make sense of our lives, we’re all wired to tell stories, and nature gave us that. For us, we wonder, ‘What is the story that our patients are telling?’ There are mother stories, father stories, ghost stories and the eternal universal story of a child trying to separate from its mother.”

So a few things. Does Ms. Kershaw want to do an article on 3 blogging/podcasting/twittering psychiatrists who like to eat together-- perhaps to coincide with the publication of their book on psychiatry?

But I'm going to tell you, as much as I enjoyed the article, what struck me even more were the comments people wrote in. The commenters expressed nothing short of outrage: psychotherapists shouldn't write, they may be manipulating their patients to get more interesting stories. One psychologist wrote in saying it's a very bad idea and impossible to be both a therapist and creative writer. I'm not sure if the outrage is at the idea that therapists are writing; I have the sense that it's more about the acknowledgement that patient stories are used. Someone does write in in defense of doing this, and cites the work of Oliver Sacks and Irvin Yalom who tell stories about their patients.

We've talked about this at length on Shrink Rap (See: The Blogging Psychiatrist). Generally we shy away from writing about our patients, and when we do, we disguise them and alter the stories-- leaving the message or the flavor. Education is important, as is demystifying and destigmatizing mental illness, and the only way this can be done is to talk somewhere about patients and what has happened to them. As fodder for novels? Well then only with disguise or distance, but no where is it said that when one signs on to be a psychotherapist there is the promise to never write creatively, to never climb rocks (--if you fall and get killed, this is not good for your patients), or to confine your activities or interests so long as they fall within the bounds of the law and certain stated ethical realms.

Mental health issues permeate the media and entertainment-- it's harder to find a movie with no psychiatric themes these days -- even Jack Bauer has an addiction problem in one season.

I don't know what happens in this particular group-- Maybe they'll invited me to visit? I'd love to come. I do, however, believe that one can be both a therapist and a creative writer. I don't write fiction about my patients; I don't offer this piece of my life to them any more than I discuss my religious or political beliefs, but it is a part of me.


Anonymous said...

I think it's terrific that these psychiatrists write. My psychiatrist is an avid novel reader and since he's a terrific observer he'd be a wonderful author, I think, offering rich insight into characters and their motives, angst, and relationships. My psychiatrist has asked me several times if I mind his sharing my stories and perspectives with other people and I gave him carte blanche to say what he wishes to whomever he chooses. He's not writing the stories for publication, but is using them for amusing dinner conversation. I am not offended and not worried about it. If he were to write a novel and I appeared as a central character with my story unchanged, I'd feel that would be an intrusion. However, if it had been altered sufficiently I would not be offended. I can empathize with not wanting the content of one's years of therapy coming out in book form unchanged. Certainly psychiatrists ought to pursue any hobby or interest including fiction and non-fiction writing, and climbing mountains.

blogbehave said...

It's tricky business but with adequate disguise, doable. At heart is the notion that we don't want a former patient recognizing herself and feeling exploited, outed, humiliated. We don't want him learning the therapist's insights for the first time in a creative writing account. We don't want the patient to read that the doctor was amused or disgusted or bored or fill in the blank. It could be traumatizing. And so many patients come to us with a history of having been betrayed by those they trust. So any form of writing with stories gleaned from the therapy setting should be done so with extreme care.

Martha Mejia-Ettel, UF '94 said...
This comment has been removed by a blog administrator.
Anonymous said...

I think if someone is ethical, they will continue that in they're writing and discussions. If they aren't, well, then they aren't and maybe shouldn't be practicing.


ChristinePAS said...

Goodness, maybe I'm just a perpetual optimist, but I have such faith in the ethical standards of 99% of practicing psychiatrists and psychologists, that their writing short stories and even novels would not bother me in the least... and I AM a patient of each. These are highly intelligent people who have devoted their careers to helping very difficult cases for relatively very little pay.

I believe a lot of the paranoia against this writing group stems from a lingering anxiety of the highly-romanticized unique brain-manipulating power and training that psychiatrists possess. Uh, right.

Frankly, it saddens me to think that people would be so angrily distrusting as to even construe in their heads a scenario in which the psychiatrist withheld or manipulated to make for a better story. The thought makes me sick, and like I said, I'm such an optimist that I don't like to think that that would happen any more often than psychiatrists already share patient stories (which I'm hoping isn't too often).

So, this perhaps foolhardy patient says, "Dinah, write on!" :)

Anonymous said...

To the person who commented "Goodness, maybe I'm just a perpetual optimist, but I have such faith in the ethical standards of 99% of practicing psychiatrists and psychologists" sorry to burst your bubble. Too many ways to count but I'll give a personal example. Being a "shrink" and part of a "shrink writing group" one of the other shrinks asked me if she could use a story I'd mentioned during a writing group in a professional paper of hers about the issue. "I'll disguise it". I agreed out of curiousity more than anything. Disguise it she did, but she also completely missed the essence of the story and situation. She misquoted and then offered up her own analysis of the situation - which clearly showed that she hadn't listened to a word or hadn't understood.
People have asked me about her as a "shrink" and the institute where she studies and teaches - you can imagine my response.

I'm in both fields and believe you can do both without cannibalizing the stories that you are ethically and honor-bound to protect.

Anonymous said...

Sometimes I want to write blog posts about things I think or feel when I'm with patients, and sometimes I sort of do. More about me than the patient.

It never even occurred to me to use a patient's story for Fiction! The stories I hear don't really lend themselves to it, and I've never been even tempted. I once borrowed a long-ago and disguised co-worker, and I borrowed a friend's story, but I told her....

It sounds like patients are afraid their stories will feel exploited, but it also seems like it might be troubling to read one's doctor's writing and NOT be there.

ChristinePAS said...

Anonymous 3,

I believe I admitted that there will be lemons out there, but said that on the whole, as a group, psychiatrists ought to be given the benefit of the doubt and considered ethical and duty-bound until proven otherwise. That you have had a bad experience with a colleague does not surprise me in the least.

Plus, the kind of literary thievery of which you accuse her is different from the issue at hand. Although you may not have liked the analysis she gave, she did indeed camouflage the patient's story sufficiently that it the real individual could not have been discerned. From what I read, she did not take the patient's story as you had related it to her to turn it into sellable fiction. Certainly her academic and professional integrity should be seriously called into question, but it does not seem that she violated any privacy laws.

I am a psych patient, but I am also in medicine. I know HIPAA, and I'm also not ignorant to the sleaziness that goes on in the realm of research and paper-writing. People, including psychiatrists, are human and therefore not perfect. People cut corners. I know. If it makes me ignorant to want to think that the honest people still outnumber the crooks, then so be it. Call me a hopeless optimist. I suppose I'd rather be slightly delusional than chronically paranoid and bitter.

I apologize if I gave you the wrong impression about me or my stance on the issue. Yes, I am opposed to patient circumstances being used for literary purposes with no imaginative (and drastic) manipulation by the author, but being the apparently ignorant optimist that I am, I believe that that would be a rare occurrence and not the norm. I absolutely think that psychiatrists ought to be allowed to write (and how might one prevent it, anyway?). As Dinah stated in her post, if you limit that, what else are you going to limit? Write on.

Anonymous said...

I too was an optimist - now, I'm just a realist. Reading previous posts and stories of controlling or abusive therapists... I'm sure those people were optimists until they met that 1% (I think it's more). It's what makes them/me vulnerable. Are they "delusional" or dealing with reality? For some, these ugly truths are reality not being "angrily distrusting" or "paranoid."

I too liked reading fairy tales about Cinderella and Snow White and living "happily ever after," but as reality would have it, my life's fairy tale ended up more like the Handless Maiden, but I'm not bitter just real. I just learned to deal with that life for me, and I'm better and thankful for it.

I wonder if the older man that laid dying in the middle of the road for 20 minutes after he was struck by a car (somewhere in New York) kept wondering where the 99% of good people were. When you are the ONE it happens to, the 1% becomes 100% of dealing with people's meanness and violations. I guess it would be okay if he was a little bitter or realistic - right?

ALFAVITA Y2K said...

Eureka, why not sending a huge number of proven mentally sane Psychologists Hollywood?

Let's say, maybe all of the trash movies written, directed and acted by degenerates and perverts as something normal would disappear and stop being a social happening.

Instead we would have again Hollywood able to produce normla movies that you would be able to want to pay for view, and even buy for adding to your collection of old B/W normal movies.

And everybody would stop scratching his head while viewing today's unrealsitic mentally ill crap, enjoying instead the wieving pleasure of a movie that was menat nad executed only by normal people.