Psychocatalytic Benefits of the Unexpected

Few doctors would say they deliberately try to catch their patients off guard, but doing so under the right circumstances can have what might be called “psychocatalytic” effects, triggering or crystallizing a change in perspective. Few doctors would say they deliberately try to catch their patients off guard, but doing so under the right circumstances can have salutary effects. Consider my first meeting with the young Ms. M. Having discovered her fiancé’s infidelity, she had impulsively swallowed a bottle of aspirin and managed to get herself involuntarily committed to a locked psychiatric unit, where I met her the morning after her admission. She was feeling scared, angry, ashamed, and betrayed — and was in no mood to tell her embarrassing story to yet another intimidating stranger. I donned my friendliest persona but got nowhere: she . . .