We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
I found Dr. Helen's discussion of the psychiatrist, Dr. Richard Friedman, who stated in the New York Times that he made politically-correct referrals, a good one, but I was confused by Dr. Friedman's premises.
Psychiatry is not all about empathy. In fact, empathy is just one of many tools in ye olde toolbox. When patients ask for a certain gender, age, color, etc. for a referral, I like to explore why. Usually it is a "resistance," ie based on the idea that someone might go easy on them and not challenge what needs to be challenged.
All shrinks have seen people who search until they find someone who will "support" them rather than shake up their world and challenge their inner problems. Kindly, one would hope, but also aggressively, because life is short. For example, a black patient might chose a black psychiatrist because "he would better understand my life." Nonsense. He just maybe might understand your surface outer life, but we deal with inner life. That is our special expertise.
I have been known to say "What you are saying sounds full of shit," and it has been quite helpful - and truly "empathic" - because it was true.
Empathy is just a tool for speaking the truth.
Depth psychotherapy for character flaws is about the doctor doing battle with a series of resistances. When one is cut down, the next resistance in line pops up. Psychoanalytic psychotherapy is a high-falutin' game of Whack-A-Mole.
I will never forget one consultation I did with a fancy, somewhat condescending middle-aged WASP lady, to assess her appropriateness for psychoanalysis. She mentioned that, if possible, she would prefer a Jewish analyst. Why? "I guess maybe because I wouldn't worry about what I said to a Jew." There was Resistance #1 handed to me on a platter: shame about what she might say or reveal. Thus she told me that shame was one of her surface resistances - part of the easy work before the subtler transference resistances kick in.
Neo-neo commented on Dr. Helen's piece, and said that she knew therapists who would not treat a Republican. In my opinion, such a "therapist" is a fraud and not prepared to help anyone, because they are clearly so caught up in their own self that they do not welcome the adventure of trying to enter another person's mental world.
Can you imagine a surgeon caring more about your politics than about your appendix? There is a little thing called the Hippocratic Oath.
Good. But there is a lot to be said for consulting a shrink with lots of surface cultural and hobby type similarities. This disarms some of us and makes us more willing to battle our character defects. Plus, if suicide is an ongoing issue, the more external positive points of contact patient and shrink can make, the better.
The wacko relatives I have gone grey worrying over have historically ignored their NHS psychiatrists because they consider them to be "ignorant plebs!" To which I repeatedly respond "But, Mummy, you're manic! She is trying to keep you alive!". Response "I'll be out of here by tomorrow, but she will still be a plebby cow!". Yeah, resistance!
Made me consider my own Mary Poppins-like checklist for a prospective shrink:
I wd only consult a shrink still married to their first spouse, a devout Christian with resonably healthy kids. Nobody with a beard, or fat. Nobody who was a gambler or an alcoholic,does drugs. Don't give a damn about their politics, but they'd better be better educated than me. A fellow Ivy or an MD will reassure me that they are smart enough to whack my deficiencies and for me to respect their brain even when my hurt pride hates their guts.if I had a pc shrink I would probably waste a lot of time despising and debating them.
Good thing I am not out looking for one, as my obnoxiousness would scare off or antagonize
Plus, coming from a family that has been mad but externally highly
functional for 400 years, we all debate pros and cons of various shrinks and therapies and meds the way normal people assess cars or horses or books,or a good flashlight. Part of getting from one place to another, exploring, testing oneself.
My cardiologist is a Muslim, at least I think he is going by his name. Anyway, I wear Israeli Defense Forces teeshirts quite often. Not to my regular appointments with my cardiologist. I do have a modicum of common sense. But, this article makes me think that maybe I should dispence with wearing them altogether in case of emergencies when I would not of planned on seeing him. I'm only principled to a point and a teeshirt is not worth dieing over.
On the other hand, Israel must be a good luck charm, as there is no logical reason for it to've survived the hatred of every madman who ever got control of a country anywhere on the planet in time and/or space.
In my son's tdp school they joke "another satisfied customer" when they hear yelling,pounding on the wall in the hallway,
as a fractious kid
is urged to "take some space". An excellent tdp because the students are expected to be honest and have a sense of humor about the problems that got them there. Perhaps satisfied or searching customers have feedback
as valuable as your peers'.when I tell my shrink that he is asleep, it is not all about transference, but useful feedback. We may be sick but we're not all crazy. In my own profession, I never learned half so much from my peers [Trollope was too kind] or professors as from the people I served..
My son and I can assess a good psychiatrist in five minutes. The customer has more at stake. The prey are far more attuned to the predators than vice versa.. Not that shrinks are predators, but the basic assymmetry in the relationship is similar.
It has always made much more sense to me that we should think of empathy far more broadly than does the therapist who sees no need to address the unconscious world of the patient. Racker's writing on concordant and complementary identifications is instructive here. We can identify with a persecutory or persecuted object and, to one who doesn't see that the identification may be with an unconscious part of the patient, we might be viewed as unempathic. When we only identify with the what is consciously regarded by the patient as part of the patient we may be merely colluding with defenses rather than being empathic in some deeper sense.