Archive for the ‘psychoanalysis’ Category

Consumer, Client, Patient, Analysand: What’s in a Name?

Thursday, April 28th, 2011

Willy Shakes asked the question in Queen Lizzie’s time (the first one, not the current monarch.) At that time he was asking because, to the questioner, a name was something that made no difference in the person to whom it was attached but made lots of difference as to how the person was perceived and accepted by others.

Insurance companies have renamed everyone who is receiving health care services. No longer are we “patients,” “clients”or, in the case of psychoanalysis and or psychotherapy “analysands.” We’re now “consumers,” according to the insurance companies. Those of us who are delivering health care services are no longer “doctors,” “analysts,” or “psychotherapists.” We’re all lumped under the title”provider,” again by the insurance companies. What does this mean? Don’t we still get treated the same as we did when we were patients and therapists, Analysts and analysands, etc?

Well, no. Not really and, on top of that, I don’t like being called a consumer when I’m on the receiving end of health care, nor do I much care for being called a provider when I’m on the giving end. Why? I’m gonna tell ya (with a nod to Dino. RIP.)

A consumer is someone who uses/purchases a good or service, which is considered a consumable. Very general. Doesn’t separate someone who is in treatment from someone who’d buying a toaster. Are you using my service? Yes. Does that make you a consumer? No. Our relationship is more personal than that, or, at least, is intended to be more personal than the relationship between someone buying a toaster and the salesman at an appliance store.

“OK. So I’m not a consumer,” you say. “Then I’m your client, right?” I’m not so sure. The dictionary on my e-reader says that a client is “a person…using the services of a lawyer or other professional person or company” (New Oxford American Dictionary.) I guess that sounds closer to the mark. I am a professional. Are you “using” my services? Well, yes and no. You have engaged me in my professional capacity. Maybe client does work but it seems to me that it misses something. It’s like chicken soup without the parsnip and dill weed. It’s may be good but it’s missing that geschmeck that makes it delicious.

What’s missing? You got it? No? Sure you do. The helping relationship. The (hopefully) healing relationship. So what’s the word now? Patient, right? Same dictionary gives the first use of the word patient as a noun to be “…a person receiving or registered to receive medical treatment.” Woah! Shazaam!, as Gomer was wont to say.) Shazoom!, as Captain Marbles said. “That’s it,” I hear you say. Well, yea and nay. Far better than consumer,  more better than client but still….

Analysand? What the hell is that? A person undergoing the process of psychoanalysis with a trained psychoanalyst. A very specific word that honors the relationship that exists in the room between us.

As for “provider….” Dad (in the stories of how family life used to be) is the “provider.” “Your father’s a good provider.” Can we talk about transference and countertransference here? I thought so.

So, what do you prefer to be called? What do the implications of “consumer” and “provider” mean to you? Add a comment and let us know. Keep those ol’ cards & letters rollin’ in (Dino, we miss you. Lots.)


Are Psychoanalysts Ever “Off-Duty?”

Tuesday, February 8th, 2011

First, a disclaimer. I don’t go around listening in to conversations at nearby tables, on the street, the bus, or anywhere else. Maybe I should say I don’t try to listen. I can’t help it if you’re going to speak loudly enough for everyone in the general area to hear you. This isn’t about why people think others need to hear what they’re saying, so enough of that. It’s just a disclaimer. Period. Done.

OK – so why the disclaimer? The other night I was walking home after getting off of the bus and there was a group of three people on the street ahead of me, two men and a woman. As I was approaching I heard a part of the conversation. One of the men said to the woman,”You’ll like him. He’s a psychoanalyst.” She responded by asking something about are psychoanalysts always analyzing everybody or do they ever turn it off. She also said something about it being tiring to always being “on.”

Do we ever turn it off? You betcha!  Tiring to always be”on?” Jeez. Probably even more tiring for everyone around than it is for us. Can you imagine that? Why would I, using myself as the example I know best, want to constantly be confronting people with their “hidden motives” for doing things? Where would my respect for my friends and neighbors be if I did that?

The people who come to me for psychotherapy are asking me to use my skills to help them.  They expect me to “listen with the third ear,” as Langs put it, to attend “with free-floating attention,” to quote Uncle Sigmund. They pay me to do this. My friends, family, neighbors and total strangers aren’t paying me for my time or my skills. They aren’t asking me to listen to their free associations and make an interpretation. I’m expected to be just another person in the room and not invade the privacy of why they do what they do.

Yeah, I’m a curious guy. Uh, maybe I should rephrase that. I’m curious about a lot of things in this world. I’m curious about what makes people tick, including me (especially me,) and seriously hope, as the old, sad joke says, that it’s not a time-bomb. That doesn’t give me the right to pry into what’s going on in someone’s psyche and, contrary to what some believe (and/or have done) it’s not a parlor game where I can (or will) look at people in the room, talk with them for a couple of minutes and then give a psychoanalytic profile.

I like my friends, family, neighbors (trust me on this.) Why would I want to piss them off by telling them why they’re doing what they’re doing or trying to manipulate them by analyzing them without their knowledge or consent. Ah, there it is – perhaps the real point of the question (OK – this is analyzing but it’s me thinking about what I might be trying to accomplish by that seat-of-the-pants analysis) is whether I would be “using my powers” for my  own nefarious purposes. To manipulate things & people.

What do you think? Do you think we ever “turn it off” other than when we sleep? Do we manipulate people? Let me know – leave a comment. I won’t analyze what you’re saying or how you say it – promise.