A few years ago I had lunch with another psychiatrist-in-training and realized we had totally different experiences with psychotherapy.

We both got the same types of cases. We were both practicing the same kinds of therapy. We were both in the same training program, studying under the same teachers. But our experiences were totally different. In particular, all her patients had dramatic emotional meltdowns, and all my patients gave calm and considered analyses of their problems, as if they were lecturing on a particularly boring episode from 19th-century Norwegian history.

I’m not bragging here. I wish I could get my patients to have dramatic emotional meltdowns. As per the textbooks, there should be a climactic moment where the patient identifies me with their father, then screams at me that I ruined their childhood, then breaks down crying and realizes that she loved her father all along, then ???, and then their depression is cured. I never got that. I tried, I even dropped some hints, like “Maybe this reminds you of your father?” or “Maybe you feel like screaming at me right now?”, but they never took the bait. So I figured the textbooks were misleading, or that this was some kind of super-advanced technique, or that this was among the approximately 100% of things that Freud just pulled out of his ass.

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DIFFERENT WORLDS