Psychiatrists Dont Just Talk About Sex

I think this was said to me for the first, last, and only time at the first, last and only mixer for singles I went to in Wichita, Kansas. I dont remember the mans name or face, but I do remember how he responded to my answer to his inquiry about what I did for a living. Psychiatrist? That sounds like a fun job. You probably get to talk about sex all the time. My response was undistinguished. No, not really. But his response to my response was even worse. Huh? What do you talk about, then? I mean they pay you for talking. It still doesnt sound like a bad job&hellip,. Strange how some conversations stay with you. I guess this one shocked me at the time because it was my first serious brush with what just plain folks thought about psychiatrists. I went on to tell him how people usually talked about emotional pain and worries, being really nervous or sad and depressed or worrying a lot. By this time, he found a way to curtail the conversation as his gaze became fixed on a woman somewhere across the room who he had obviously perceived as more attractive than me. I guess I have been a bit of a manual laborer when I was a surgeon. But aside from that, I never saw myself as doing anything but talking for a living. Not that it is anything like conversational or fun talk. Very focused. Often I have to interrupt or redirect a patient to ask pointed questions in order to get the information I need to make a crucial decision about diagnosis or treatment. Most folks dont mind much but some live this as extremely difficult. I do try to get a marital history, maybe a relationship history. When sexuality comes into it, there is certainly nothing titillating about it. Usually it seems to be a woman telling me about poor treatment by a husband or lover. Such treatment ranges from insensitivity or indifference to severe physical abuse. I thank them for honoring me with their confidence. There are certainly male victims of abuse, too. But it says something about sex roles that women rarely try to impress me with their physical attributes. Oh, sometimes one will complain to me about what a terrible burden it is to go through life with excessively large (and seductive) breasts, even pointing out to me that I do not look like someone who would empathize with that sort of problem. But it is not terribly rare to see a male human who is a bit on the manicky side tell me about his great sexual prowess and abilities. I plead professionality (which generally seems to accomplish surprisingly little) and show off my lovely wedding ring, which generally seems to wield a bit more power of dissuasion. I dont think anyone is actually terribly shy about discussing sex, in this day and age. I see some people, however, who tell me things are just fine, and it may not be necessary or helpful for me to try to dig deeper. I see other people who are downright obsessed with sex people to whom I often hear myself saying something like You just cant do sex 24/7. You have to at least talk to other people, maybe earn a living or such. So what I do hear, if someone tells me about sex, can be cruel and even repulsive. In the days when I took some lectures in psychoanalysis at the Menninger Clinic in Topeka, KS (now relocated to Houston, TX), the full-time students of psychoanalysis underwent a desensitization process that included they told me standing in the middle of a room with pornographic movies, perhaps a bit heavy on the sadomasochism, being projected on all four walls. I was not enrolled in that particular curriculum. Me, I was turned off of the study of psychoanalysis early on, when a bearded Freudian scholar told me that women could not have real friendship with each other as they had to compete with each other for mates. Me, I thought then (and still think now) that sisterhood is powerful and that men sublimate (or at least repress) an inclination to murder or violence by engaging in competitive sports. Nevertheless, the classic (Freudian) notion that we all have deep animalistic urges that need to be sublimated (or repressed) to get through life rings true. His concepts of id, superego, and ego are useful, and cannot be disregarded, even by a medical-model pharmacologist like me. I am surely not the first one who noticed their similarity to nefesh, ruah and neshumah, ancient rabbinical (yes, Jewish) concepts. But the medical society of Vienna was doubtlessly not terribly evolved in any knowledge of or interest in such matters. (NOTE: Freud was Jewish, in case you didnt know) Basically, the superego is our high-minded morality, the id is our animal nature, and the ego is our daily reality, the part of our lives that tries to get things done, schlogging through life trying to reconcile the two. Sometimes I see people who surprise me a bit by being feral more like a wild beast than a civilized human. Me, I am all kinds of citified and gentrified. Some have even opined that I am overeducated, but that was usually the opinion of men I dated prior to dating my husband, some of whom engaged in manual labor although they did not appear to have yet evolved opposable thumbs. I have been surprised, for example, by men who live in rural areas who have told me about expressing feelings of ownership of or dominion over land, by urinating on it. I really dont know how to explain this any other way except id, or animal instinct. The concepts of transference and counter transference are another precious gift from the Freudians. Every time a person enters into a room to start a new relationship, they carry the baggage of every relationship they had before. People relate to me in certain ways because I am female. A female with authority and, as some friends have said, more degrees than a thermometer. This is transference the aspect of sex I have to deal with every day. When I was heavier, people thought I reminded them of their mothers. Now that I am thinner, even though I am older, it is sometimes an old girlfriend or sister or (heaven help us all) an ex-wife. These feelings and memories are so powerful, so real, that they can be a serious handle on understanding relationship patterns and problems. Ours is still a young and imperfect specialty, but this is far cry from getting jollies by talking about sex. If there is a new taboo that has replaced sex, it might be talking about money. People who dont know where their next meal is coming from are often ashamed to tell me, even though I have pretty much figured out how to get them financial benefits and send emergency food to their houses. Money and Sex societys major taboos. Its not all that we shrinks talk about but I have to admit these topics take up a lot of our day. Author’s Bio: Estelle Toby Goldstein, MD is a board-certified psychiatrist in private practice in San Diego, CA. Practicing Medicine Since 1981 In her medical career, she has studied in Europe and Canada as well as the USA. She has attended specialty training beyond medical school in the fields of general surgery, neurology and neurosurgery and psychiatry (specializing in psychopharmacology). Experienced In Many Situations She has worked in a variety of positions, including: Fireman/EMT Medical school professor General and Orthopedic surgeon Brain surgeon Army Medical Corps psychiatrist Prison psychiatrist Community Mental Health Center staff Consultant to a major transplant hospital Drug researcher Whatever It Takes! She currently has her own indepenent clinic in San Diego where she is concentrating on what she calls Mind/Body medicine or Integrative Medicine. Her practice is cash-only, doesnt accept insurance or government payments, and she operates on the concierge, or private doctor practice model to give her patients the absolute best quality of care and the highest level of confidentiality. Dr. Goldsteins philosophy is Whatever It Takes! Her goal is to do everything possible to solve whatever problem she is presented. This includes seeing patients as quickly as possible not making them wait weeks for an appointment. This includes making appointments days, nights, weekends or holidays. This includes making house-calls. And it includes using the best, most innovative treatments available most of which are unknown to standard, mainstream doctors. Her focus is on transitioning patients away from prescription drugs and onto natural substances. She is also a master practitioner of Emotional Freedom Technique, a powerful and dynamic form of energy psychology that usually brings quicker results than traditional psychotherapy. The Experts Expert She has written an advice column in a daily newspaper and hosted a weekly call-in radio show, and now is enjoying the freedom of speaking her mind on this blog. ( function() { if (window.CHITIKA === undefined) { window.CHITIKA = { ‘units’ : [] }, }, var unit = {‘calltype’:’async[2]’,’publisher’:’selfgrowth’,’width’:300,’height’:250,’sid’:’Chitika Default’}, var placement_id = window.CHITIKA.units.length, window.CHITIKA.units.push(unit), }()),

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