We’ve all seen the television psychiatrists. My personal favorite is Dr. Sydney Freedman from M*A*S*H. For those of you old enough to have seen the program or anyone who watches the program on cable, Sydney Freedman is the perfect psychiatrist.
As a child growing up with two severely mentally ill parents, I was certain that Dr. Freedman was going to knock on our door and magically rescue me. He had it all, the perfect bedside manner, empathy, wisdom, vast clinical knowledge, and as a bonus, he was funny. Who wouldn’t want him as their psychiatrist? He was perfect.
I carried this image of what a psychiatrist should be into my adulthood … until I met my first psychiatrist. Dr. W was no Dr. Freedman. He was prickly, distant, and humorless. I hated him. I wanted Sydney Freedman and I got Dr. Sullen. I was miserable. So, I did what we all tend to do, jump ship in search of Dr. Perfect. The problem was, Dr. Perfect never materialized. I’ve had outpatient psychiatrists, countless inpatient psychiatrists and not a single one of them was Dr. Freedman. This made me disappointed and frustrated.
Then I met my current psychiatrist, and I learned something. Unrealistic expectations were destroying any chance I had at having a healing relationship with a real doctor. I was sabotaging my own recovery because I was hunting for a person who did not exist. Once I understood that I needed to deal with a real person and not a fantasy, my ability to deal with any psychiatrist vastly improved.
Let’s just face facts. Our psychiatrists are human beings with their own unique qualities that we can tap into to facilitate healing. Had I stuck it out with Dr. W and appreciated that he wasn’t sullen and distant but rather a careful listener who picked up on the nuances of my mood and illness, maybe I would have stayed. He was a careful diagnostician. Even though I was a terrible patient, meaning I withheld information, was noncompliant, and really resentful that I had to see him at all, he diagnosed me correctly and medicated me appropriately. True, he wasn’t Dr. Freedman, but he was a good psychiatrist in his own right. Looking back, I realized I misjudged him.
Several years ago, I wrote Dr. W and told him this. I felt I owed him an explanation for my awful behavior. I never heard back, of course, but the letter gave me closure. I was able to express my appreciation for his work with me and let go of my disappointment in my own behavior. It was a healing letter.
Unreasonable expectations are a significant reason why so many of we patients are unhappy with our doctors. The sad part is we are sabotaging our own care because we have an image of perfection in mind that no doctor can meet. Those of us with severe illnesses depend heavily on our psychiatrists in times of crisis and distress. Of course we want them to be attuned to us and sensitive to our needs. The problem comes when we unrealistically expect a level of perfection that is just unfair and destructive.
There is a happy end to my story. Once I understood that the attitude I brought into my relationship with Dr. Guterson played a key role in whether my relationship with him was going to succeed, I made space so that I could let go of Sydney Freedman and appreciate the skills of Dr. Yaakov Guterson. He and I have been psychiatrist and patient for 23 years. Has the relationship been without rough patches, no. However, the process of working out those difficult times has helped me heal, and I use those same skills in my non-clinical relationships.
By sticking out the difficult moments, I have learned problem solving skills, collaboration skills, and conflict resolution skills. I have become an active participant in my own recovery. I’m a healthier person because I was able to let go of a fantasy psychiatrist and work with a real live one, imperfections and all.