Transference, Counter-transference — Don’t Be Cruel To Your Shrink

She hated my guts from the moment she walked in the door.  No — before she even walked in the door.

We shrinks have one of those psychobabble words describing what she did to me — “transference.”

I have feelings, and I am a human, so it is pretty hard to take care of people who hate my guts.

No, I am not exaggerating.  She told me how horrible psychiatrists are, how they had screwed up her life without listening to her own description of what is going on — and I had a feeling she was telling the truth.  These things do happen.

Her main assertion was that she was not manic-depressive. And you know something? The way she denied all of the signs of that now all-too-common illness, she was either correct or the best liar in the world.

I wanted to side with her.  She would not let me.  She estimated my age from my appearance and told me she knew I had been a substance abuser in the swinging sixties. I hadn’t of course.  Quite the contrary — I was a substance avoider. I remembered distinctly having run like a bat out of hell from a party in Paris where chicken a’ la hashish sauce was the main dish.

Even before that, I ran even faster from a party in Boston where garden variety marijuana was present.  First and foremost, I’ve always valued my brain cells and done everything I can to avoid killing them with alcohol, drugs or other things. But more importantly to me — with a felony you can’t practice medicine, and that has been my life-goal since before even entering elementary school.

Transference.  The patient described above, a woman almost exactly my age (born three days after me, same year) reminded me of what I have always thought was an acting tour de force; Barbra Streisand in “Nuts.”

Despite popular belief (and a wonderful Saturday Night Live skit called “Coffee Talk“) Jewish women do not sit around discussing and praising the body of work created by Barbra Streisand.

Humans have feelings, and it must be hard to keep in mind that your shrink is human.  I sometimes feel I have too many feelings.  I can usually keep my calm and not get angry at patients.  Sometimes I raise my voice and recite the uniqueness of my credentials, namely that I am the only person in the room trained to know what is going on. But that tactic is usually reserved for people whom I judge will react best to authority.

Sometimes when you start out in this venerable career, patients remind you of people in your family.  That is called “countertransference.” My brother was the guy whose brain I had dreamed of saving so I thought everybody was like my brother, but they did not try as hard and simply were not as good patients as he was.  I remember my supervisor in my child psychiatry rotation who helped me distance and learn to admire young hoodlums for the way they work the system, something I know my simply sincere brother of blessed memory could never have done.

I had to distance myself from this woman who thought my credentials confirmed my hypocrisy.  I played it cut and dried, offered her a simple treatment, told her to take it or leave it.

You can’t ignore personal security however, especially when a patient is as angry as the one facing me.  I actually had two males in the room with me nurturing me.

But I beg of you, instead of raising the voice try to be nice to your doctor.  She/he are also human and have feelings. Pretty please.