Meet Dr. Receptacle

I first learned that I was a “receptacle personality” in Baltimore, Maryland.  I was serving our fine country in the US Army Medical Corps as psychiatrist to the 82^nd Airborne Division in Ft. Bragg. NC

There was some sort of a training group there that all of the other active duty psychiatrists seemed to have attended.  The Army – in its wisdom – had decided to take me – a trained neurosurgeon – and make me a psychiatrist.

Our country needed me (in this position, at least) and I obeyed, like a good soldier.

As an “On the Job” psychiatrist, this training had been “heavily recommended” — not a signed order, but it was clear from my command that this was something I really, really ought to do.

So I went — out of uniform, as I had been told.

You must understand that psychiatry is a boarded specialty, and only after I left the military did I serve a formal residency to learn this special skill (as well as a fellowship is psychopharmacology since psychiatry was on the way to turning in to the art of “pill pushing.”)

The group did not require any kind of preparation.  Being on the east coast, even the mid-Atlantic, had a feeling of familiarity, with the kind of older buildings and close interpersonal spaces I had known during my childhood and early youth in Boston.

I flew up from Fort Bragg (Fayetteville) North Carolina.  The Army gave me time off and paid my modest single-girl travel expenses.

The group met in various brick buildings, small and close together, that reminded me a little of Harvard Yard in Cambridge, Massachusetts, which had been one of my father’s favorite places to visit and revisit, from his own college days.

It was some sort of a hospital/university/mental health complex.  I remember that someone told me part of it had been the “Chestnut Lodge” once associated with the great American psychiatrist Harry Stack Sullivan.  I’ve got a PDF behind that link which will either open a new window and display in your browser or download to your hard-drive.  You will need the free Adobe Acrobat reader to access it.

His contribution was significant, but frankly, Dr. Sullivan had been part of the psychoanalytic movement, doing some pretty intensive analysis of why folks did the things they did.

I think this sort of thing is indeed valid and useful.  Nevertheless, I was an ex-surgeon trained in psychiatry through a program at the University of Kansas, thus operating nearly entirely on the “medical model.”

In practical terms, this meant find out what is going on medically, push pills as needed.  Then refer to a (more local when possible–there are simply more of them than physicians) psychotherapist to do the “talk stuff.”  After all, we were expected to spend only one year in the study of “talk therapy” and they had their lives to do this.

The woman who told me I was a “receptacle personality” was a senior analyst (female) who later told me she was only a few months from retiring completely.  She was thin and looked hardened a bit, with the purest white hair.  She had the light of a lively and (I thought even perhaps brilliant, even before speaking with her) intelligence in her eyes.

I can’t remember her name.

Prior to her, I had met only two or three other female psychiatrists; and quite frankly, I had not much liked them.

One had been a foreign medical graduate – but being French-trained (and proud of it) I am the last person in the world who would judge negatively because of that.  But she seemed old and tired, and said everybody needed “supportive therapy,” which as far as I could tell was not what I wanted patients to get.  It is more like “friendly talk.”

She was no psychopharmacologist, either.

Another insecure female — I considered possibly an irritable manic — who treated me more like competition than like a colleague.

But the senior female analyst was — well, there to analyze me, in a way I did not want or need to learn, and she had been doing it for a long time.

I had been told by the military psychiatry command that it was “kind of like” a Balint Group.

A Balint group is a bunch of physicians, not necessarily psychiatrists, who get together to review their diagnostic process.  This makes a tremendous amount of cosmic sense, as medicine is not a science that is as objective as, say, physics.

Doctors tend to have patterns in which they diagnose the same thing repeatedly.  I guess they project themselves into the diagnostic pattern in some manner.  I had noticed this when I was only 18, starting my medial work in a not particularly auspicious job at the front desk of a major Boston Emergency Room, unceremoniously plucking medical insurance cards from people’s wallets.

What diagnosis we saw the most of was clearly related to which doctor was on call and seeing patients.

I would have delighted in going to a Balint group had I ever been in a city or institution that had one, but they did not seem to be in the places where I hung around.

The purpose of the Baltimore group was not something we could learn until the two or three day group was over.

We went to assigned rooms, maybe a dozen or so of us in each, with an assigned group “leader.”  The “Leader” remained totally silent for the first session of a couple of hours.  The next session, we were given a few comments on our ways of interacting with others in the group.  The escalating pattern continued through subsequent session with more and more transference analysis until our closing individual analyses, mine by the wonderful woman analyst.

Me, I had no idea of why we were there and what we were “supposed” to do.  I was open about it, stood and addressed the group, and they rallied behind me as I tried to address the group leader, who had little to say.  I got fairly aggressive, questioning the process being used, and what we were to get from it.

People seemed friendly to me, and I actually took home some names and addresses.

These were the days before email was in general use.  Otherwise, I suspect I would still be in contact with some of them.

Although she told me other things, what I remember far and away most clearly is how she told me I was a “receptacle” personality.

I had to stifle laughter when she first mentioned the word.  I thought it was obscene.  Or maybe, just “feminine,” like committing suicide by drinking poison (as opposed to shooting yourself) or even the suit of “cups” in the Tarot.

She had a soft half-smile.

She told me, as a strong and comparatively fearless and hangup-free woman, I was a “receptacle,” so people would project very strong feelings onto me.

Luckily for me (I was told), most people love their mothers, and most patients love their mothers, so most patients would love me (they generally do; honest).  But there are people with all kinds of sick and crazy mothers and they are going to hate me (yes, she used the word “hate,” to my amazement) and it will not be my fault, but I need to remain as objective as I can and try to grasp these feelings, for that kind of knowledge and power is priceless.

She gave me the ability to understand people who seem to hate me for no reason.  Yes there have been some.

Even more important, she gave me the capacity to forgive them.  This is primordial and basic, almost religious in importance.

I have had experiences where I felt the world was condemning me, and explained them away in this way, and carried on.

This is indeed a precious gift.

I suppose psychoanalysis still exists in some form or other, but the media stereotype of flipping someone on his/her back for five hours a week and make them talk about mother does not exist. The classical mode of looking at how people do things and why has been lost in a world where I believe insurance adds cost to care instead of adding value.

Me, I go on.