As a psychologist/psychotherapist, I have always found it fascinating the ways in which strangers react whenever I inform them that I’m a psychologist. To avoid awkwardness, I know many psychologists lie about their profession to total strangers. It is interesting to note the ways in which strangers respond to my disclosure. I also think it opens up a window into the ways in which Americans thinks about psychotherapy.
One of the major responses I hear from people is “well, we’re all a little crazy, right?” Cue the nervous laughter. In these moments, the stranger is often dreading some sort of mini psychological evaluation and attempting to avoid my (fantasized) all-seeing eye by demanding that I give him/her a clean bill of health. Here I am being placed in the position of the subject supposed to know. While I do have a honed mind based on experience and study, ultimately it is the patient’s unconscious that “knows”. This projection of unconscious knowledge leads to all sorts of interesting social interactions. Returning to the stranger’s questions about craziness, the stranger seems to be communicating, “I’m very uncomfortable in your presence and anxious about my unconscious. Could you please set aside your “psychological hat” so I can avoid my punitive superego and unconscious?” At the same time, other strangers (perhaps the more hysterical and less obsessive individual) takes my disclosure as some sort of ‘green light’ that s/he might be able to get some free therapy. I had this unfortunate experience recently while on a plane. I try my hardest not to talk to strangers because I generally find books more interesting than people, especially because plane rides are excellent opportunities to catch up on reading. Given that these are the typical responses, it’s no surprise that most psychologists often lie about their profession.
Another major response I’ve encountered is “can you shut off your psychological mind when you’re not doing psychotherapy?” While this is a moderately interesting question about drawing boundaries between the personal/professional, the underlying fantasy seems to be in alignment with the first response wherein the stranger appears anxious that I will be able to peer into their very soul. Often, when the stranger is more honest, s/he will say, “I hope you’re not analyzing me.” Again, cue the nervous laughter. In my more aggressive moments, I often respond, “sorry I only analyze people who are interesting.” Over time, I’ve become impressed with human narcissism and the belief we all have (myself included) in our inherent interestingness. This belief is hiding behind the stranger’s belief, as s/he appears to believe that I would want to analyze their mind.
These first three responses are largely positive and betray a belief in the inherent power of the psychologist. The major takeaway from these interactions is that the psychotherapist is an omniscient figure from whose all-seeing gaze there is no escape.
Another major set of social responses is largely negative. First, I have encountered skepticism. “Does psychotherapy really work? Can people even change?” Assuming that the stranger is not really interested in psychotherapy efficacy research (spoiler alert: it does work), we can assume that the stranger is clinging to this rigid belief because of fears that s/he could change some self-destructive pattern or personality trait that is causing suffering. Next, we have all these weird fantasies about the devious and insane nature of psychologists and psychiatrists. “You have to be pretty crazy to listen to crazy all day.” Just think of the ridiculous ways in which psychologists and psychiatrists are portrayed in pop culture. Barring the psychoanalyst off the Sopranos, most depictions are completely bizarre. In many cases we have therapists with terrible boundaries who seduce their patients. Or we have the sadistic psychiatrist who gets off torturing his (note: this season of Dexter is doing female psychiatrists a service by making both male and female and psychiatrists appear psychopathic) patients. It makes one wonder how many movie directors have acted out their frustrated erotic and aggressive transferences towards their therapists by creating absurd caricatures on film. Another major response is perhaps the most annoying. This is the “tough guy” attitude which envisions that psychotherapy as some sort of hand-holding, coddling exercise wherein the patient blames everything on others. In their mind, psychotherapy is for “pussies”. This weird feminization of psychotherapy is probably driven by the anxiety that the “penetrating” all seeing eye of the psychotherapist might be able to see something that is anxiety-producing for the stranger. As a result, the psychotherapist is castrated in the stranger’s fantasy as to way to defend against this anxiety.
After reviewing all of these fears and fantasies, it is obvious that being a psychologist is a very weird profession. We are both respected and dismissed. Desired and feared. It’s a wonder patients are able to push past these fears and fantasies to even enter into the consultation room. More and more, I’ve become impressed with the patient’s capacity to speak and act honestly in the face of overwhelming anxiety and fear, which I think is a good definition of courage. Psychoanalysis and psychotherapy are interesting human endeavors. When someone enters into treatment, it is usually safe to say s/he is suffering. This individual also knows that psychotherapy will produce more suffering. The trick for the psychotherapist is to somehow convince the patient that the suffering that s/he will experience in psychotherapy is worth it.
Returning to the “tough guy” attitude, it is patently obvious that these people are defensive and terribly uncomfortable with being honest. They don’t want to think about anything and they trivialize their emotional experiences. In reality, psychotherapy is ultimately an act of courage because, when I interpret, I am drawing the patient’s attention to realities that are extremely painful such as: trauma, madness, death, loss, abandonment, rejection, and self-sabotage, i.e. the darker sides of human nature. As Lacan noted in Seminar VII, psychoanalysis entails an ethics of responsibility, even responsibility for our unconscious. So, it is extremely curious to me why there is this pervasive fantasy that psychotherapy is about blaming others whenever, at least psychoanalytic therapy (which is admittedly no longer in the majority for many complex reasons), is all about realizing the fact that we are responsible for all of our actions. Things don’t just happen. Everything has meaning. This is not to deny that there are actual victims or accidents or things beyond our control (e.g. social realities). However, as long as we continue to tell ourselves that the world happens and we are passive recipients (external locus of control), we are doomed to react. If psychoanalysis is ultimately about a realization of one’s unconscious desire and fostering a sense of agency to pursue those desires, then what is key is helping the patient recognize they have chosen and are unconsciously invested in their symptoms (e.g. pathological relationships, intense anxiety, anger-regulation problems, obsessive thinking, etc.). This is why psychotherapy is an act of courage. People spend their entire lives running away from these truths and many go to their grave never confronting them. No wonder why the psychologist in public is greeted with such manifest ambivalence.