The shrink and the client

Perhaps, it has happened many times to many people in the mind mending profession, but the first time it happened to me, I was suitably stumped. Well, there was this lanky young software professional who was so sociophobic that he decided to attend a soft skills training programme at my centre. There I was diligently training him in assertiveness, emotional intelligence, transactional analysis, kinaesthetics, etcetera etcetera, when one fine day he announced a new problem. He was having trouble concentrating at work, as he was obsessed with the image of a woman…. And with many a hiccup he blurted out that the woman haunting him so was me. He painfully professed the deepest love he had ever felt and I for once was speechless!

As I lapsed into Mode Mute, busy racing through my mental algorithm trying to figure out the best possible management of this emotional malady, the patient exhausted his rendering and looked up at last. I promptly told him that I needed a second opinion from a senior psychiatrist regarding this new complication and bid him adieu for the moment. I consulted my mentor and put forward the great idea of referring the patient off to him. Mentor mine refused to be saddled with Mindwreck mine. He predicted that I would have to handle more such similar complications in my psychiatristyears ahead and advised me to psychoanalyse this and such other patients out of this Appreciation Superfluxitis. Which I did. But during the course of this Transference Management I inadvertently slipped into bouts of deep introspection. And could not help but ponder over how my male colleagues handle the converse of my situation.

I had of course heard earfuls about doctor- patient dalliances, of various degrees of trespass from various sources. There are umpteen non-specific hearsays of male doctors making lewd innuendoes to their trusting lady patients. Specific cases include this particular lady who whimpered about her previous psychiatrist’s polite request to fellatiate him. Then there was this social welfare officer who expressed disgust at the indecent proposal made by a psychiatrist to a recently bereaved widow. Reports also abound about this senior shrink who in the name of an in camera Mental Status Examination, makes furtive groping of the sound bodies of unsound minded women. There are, I hear, quite a few shrinks who go on to the extent of establishing non-therapeutic alliances with their clients, some all the way up to marriage. Also around is some news about gay doctor- patient liaisons.

Conspicuous as the male slant of the graph seems, one wonders if the women patients in all these instances were truly guileless or is it the case of cotton instigating the fire. For there are also many reports of female patients offering more than just their minds for examination.

The other dimension is the less remarked about lady doctor versus male patient relationship. Does the paucity of grapevinery about such liaison merely indicate paucity of practising lady psychiatrists? Or as many lady psychiatrists confide- troublesome male clients are more likely to turn crude and play, “Me Tarzan, you Jane”, kind of who’s-the-boss-here games. Does such machismo cause more irritation than ignition of passion, which then by negative feed back seals off opportunities to indulge in Professional Incest? Or are the lady shrinks too fastidious to consider coquetting male “after all” patients. Or are the ladies too smart to be heard about? Or is it the ‘No Testosterone = No Philandering’ Equation?

That made too many questions for Small Mind Mine. I spoke to some very erudite shrinks about this. One of them narrated his experience with a lovelorn lady patient who even on the day of her wedding insisted that the good doctor be there to expunge her grief of marrying someone else.

Another shrink told me about his histrionic client who repeatedly let her saree fall off her shoulder. When he nonchalantly ignored the lavish spread, the woman got so pissed off that she called him a “ No Man”. Of course, our man remained completely unruffled.

One other male shrink told me about his unwed wrong-side-of-thirty patient who pleaded with him to give her a baby to satiate her maternal longings.

There are plenty of stories of sexually frustrated women throwing themselves at their doctors - shrinks or otherwise. As also are instances of shrinks using their bodies rather than their minds to treat sexual dysfunctions of their clients.

Such prevalence of this occupational hazard calls for collective introspection on the Other Side of the Shrink-Client Relationship. Why do clients fall for their shrinks? Well the answers range from Positive transference and Negative self Image, to Supplication display, dominance-submissiveness dynamics, people- pleasing tendency, sense of indebtedness, and the lot.

Sometimes it so happens that the client does not actually fall for the shrink, but is merely trying to use sexual invitation displays to win favours such as better treatment, lesser fees, more time spent, etc. Such remotivating tactics, ethologists opine is quite common among mammalian, especially the primate, species.

That answered, there comes the more important question: Why do shrinks fall for their clients? The answers go all the way from reckless impulse, malnourished ego, porous superego and run-amok hormones, to the “no-one’ll ever know” certainty, intimacy versus isolation complexes and the underlying primeval lust.

That also answered, there comes the most important question: is it okay for the shrink to have a toss with his/her client? And this time there are no multiple answers, the unequivocal answer is NO. Whatever the reasons or the explanations, even the perpetrators of such acts consider it immoral and unethical.

For plain and simple human beings, abound with basic instincts, we may all be. But when it comes to being a professional mindmender we are expected to transcend above the human realm and take an extrahuman stance. We are to uphold the nobility of our specialty, by practising Professional Impotence. We are expected to be selectively immune to all the temptations of the client - flesh.

It goes without saying that such compartmental libidinal cathexis is not easy to come by - to remain keenly reactive to our senses outside of the sexual sphere, yet synchronously suppress the eros in our psyche - is quite an oxymoron in itself. The startling finding is, given the improbability of such selective asexuality, it still happens to be the default mode in a majority of us psychiatrists. And that singular distinction makes me marvel - not at the incidence of sexual indiscretions among shrinks, but the lack of it in the vast majority of us. Kudos people – that makes yet another just reason to be proud of ourselves!