Psychiatrists Behaving Badly

It’s really a cliché’ and may have some basis in reality:

A psychiatrist (Male, of course) has his patient (female, of course) lying on the couch and telling about her dreams or playing “word association” or whatever psychiatrists do – and then they have sex.

But, fellows – if you really want to score with the babes, this is not the way to do it.  Medical school and post-grad studies are darned expensive and take years.  “Ladies Night” at the bowling alley will probably get you into the sack a lot sooner.

The first time I was asked to supervise (monitor and attempt to bolster so he did not sin again) a psychiatrist who had sex with a patient was in Wichita, Kansas, when I was the most junior of faculty members. As a matter of fact, I learned a great deal of things as I was “ordered” to do things nobody else wanted to do — like to teach the psychopathology of sex to psychiatric residents.  What I learned then helped me enormously years later, when I worked with transgendering folks. I remember being surprised earlier in my career when several patients told me they thought I had a wonderful job because I got to talk about sex all day.  Not only do I not talk about sex all day, I rarely discuss it.  Not that I am not interested, but there are specialized therapists for this.  Gone are the days where pretty much everyone sees an analyst, and the “Grook” by Piet Hein may have held true:

Everything is either concave or -vex,

So whatever you do must be something with sex.

Male psychiatrists coupling with female patients is old news, and long a staple of popular fiction (See F.Scott Fitzgerald’s “Tender is the Night.”) Then there is the standard joke about “double-dipping” – where a psychiatrist not only enjoys the charms of his patient (it’s always the males, right?) while charging her insurance company for the “therapy” (and her for a copayment).

Except, it actually happens – maybe that’s how jokes are born? Someone tried to use sex as therapy to diffuse tension.  Believe me, the majority of shrinks would use biofeedback, hypnosis, relaxation exercises – or probably drugs. I reviewed the literature when I started to supervise this young psychiatrist (who slightly resembled Brad Pitt).  He was then what was considered the typical profile for this infraction — going through a divorce and thus, not having his sexual appetites fulfilled. I know plenty of French colleagues who would have suggested he be given a gift certificate for a whorehouse.

The real life story is much more mundane.  And that’s generally the truth about psychiatry.

Nobody really knows what psychiatry entails if all they do is watch TV or movies.  It is not a comedy sketch with a wise-guy reclining on a couch doing a monologue while the shrink feeds him straight lines.  That’s Woody Allen or Bob Newhart.  There may be people who do dream interpretation and ask about your mother, but generally those aren’t psychiatrists.

No psychiatrist I can think of has ink blots hanging on the wall and is asking you what you see.

And just as not all bankers are embezzlers, and not policemen are on the take, not all psychiatrists are having sex with patients.

Only in the movies – or maybe in their dreams.