Inside The Mind of a Psychiatrist

A patient reminded me about the November 1978 Jonestown massacre. 913 members of The People’s Temple cult committed suicide by drinking grape-flavored Kool Aid laced with potassium cyanide. Their leader, Jim Jones, after a number of practice sessions, ordered the entire cult to drink the deadly mixture. They did exactly what he said!

Psychotic, crazy, mass hypnosis, gullibility? Probably all.

Is it that much different now, 34 years later?

Charismatic preachers, acting like messengers from some crazy god, continue to have enormous religious and political power. In their eyes, birth control and homosexuality are clearly a sin. Now the preaching has taken on an even crazier tempo. Republicans are battling each other to prove who is the “true” conservative.

As a psychiatrist, I often wonder what is really going on. Am I the crazy one? If I don’t believe, will I not get into “The Kingdom”, or wherever religious fanatics go who are true believers? Whatever their fantasy might be, I’m not interested in joining them.

When a patient is overtly psychotic, logic doesn’t help. Talking to rigid evangelicals also won’t help. So what will?

Join groups like Planned Parenthood, work to have all 50 states pass equality laws supporting gay rights, speak out against any school that won’t teach evolution, speak out against any use of violence to advocate a religious belief, and do whatever you can to expose any hint of terrorism that will limit our right to have the freedom to come to our own conclusions about the world.

Because so many people need to drink Kool Aid, doesn’t mean that we have to respect or ignore the dangers that it breeds.

Any thoughts?

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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.

“What?”

“I know why I’m so angry…”

Silence.

“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?

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