I’m sitting in my psychiatrist’s office and my mind’s a blank. Nothing in there.

After a minute of silence I say, “It’s costing a fortune to just sit here. I have nothing to say.”

The doctor nods, not in an unfriendly way, but also not very helpful.

“Maybe you’re just sitting there thinking about lunch; or napping with your eyes open?” I laugh, but it comes out a little too high-pitched. The sound of my wimpy laugh really annoys me. I blurt out. “What a great way to make a living. I do all the work and you get the money.”

“What work are you doing?” The doctor asks with a wry smile.

“What work? Well maybe I’m not doing anything, but you’re still getting paid.” Now the doctor thinks he’s a real comedian. Next he’ll be auditioning to MC the Oscars.

“You’re pretty angry this morning. What’s going on?”

“I don’t like you today. There’s an arrogance, a kind of power you have over me. Who do you think you are?”

Silence. A quizzical expression is on the doctor’s face.

I glance out the window at the sky. I don’t feel like looking at the son-of-a-bitch.

Finally I say, “You know my insurance pays almost nothing for this. It all comes out of my own pocket. Obamacare, Oshmamacare, certainly isn’t helping me!”

The doctor nods, like he agrees.

“Screw them! The idiots in Washington. I’m furious!”

The doctor nods again.

“Shit!” I shake my head and close my eyes.


“I know why I’m so angry…”


“I spoke to my father last night. He’s such an insensitive jerk! I told him how boring my job was, how I need to find something more fulfilling. He said, ‘I worked at the same job for thirty years.’ I ended the conversation and watched the Lakers. They even lost! Does he want me to be just as miserable as he is?”

“Maybe he didn’t understand how unhappy you are?”

“He was NEVER understanding. Ever! My mother says the same thing. It’s been going on my whole life.”

This is an example of how psychotherapy and the concept of transference works. The patient transfers angry feelings from a parent (or another important person, usually from the past) to the psychiatrist. Often it’s more complicated. The feelings aren’t so much on the surface, but hidden in the unconscious part off the mind. Sometimes a patient can be angry for weeks or months at his doctor, but eventually the original source of the anger is clarified. As the old wound is being relived in the transference, it can be examined in the safety of the psychiatrist’s office. Once it’s out there, and not being repressed, the issue can be dealt with in a more productive manner.

Any similar experiences or ideas about the unconscious or transference?

Don’t forget to subscribe to Inside the Mind of a Psychiatrist.

5 thoughts on “WHAT HAPPENS WHEN YOU HAVE NOTHING TO SAY TO YOUR PSYCHIATRIST? by Art Smukler, author and psychiatrist

  1. I was a little surprised that the Psychiatrist would volunteer the conjecture that “he didn’t understand how unhappy you are.”

    I’m enjoying your blog. I read many of them, though I don’t often comment. Good job, Doctor!



  2. I think we all transfer to some extent. If we are annoyed with ourselves we get grumpy and snap at the kids. If we are in pain we get stroppy with the double glazing salesman (not a good example as most people get stroppy with them even when not in pain).
    As someone who suffers from fibro and gets upset with myself for not being the person I was and is in pain 24/7 I transfer my feelings from myself to others. If I catch myself I apologise profusely but it does happen.
    The same with having had a bad day at work and yelling at the bus driver for being 10 minutes late. Or if the kidskept you awake all night you arrive at work in a foul mood and take it out on your secretary. The list is endless and most of the time we don’t realise we are doing it, we really think the people we snap at are at fault.
    Psychiatrists are at fault for a living and are paid to get it in the neck until the patient realises why they are acting up. Bus drivers, bar maids, double glazing salesmen… they just have to put up with it.


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