Psychiatrists’ Offices

Over at Tony White, there are two posts (1, 2) about home visits. It was a fascinating series and got a lot of reactions. Go read them first.

I used to make a lot more home visits, especially with the palliative care service. I never ever was sorry. I found so many things I’d never know about people. An elderly, extremely poor woman had a huge aquarium of tropical fish in a beautiful apartment with furniture that was highly stylish and I’m sure expensive in the 1950s. Once I saw a mildly retarded woman and discovered that she desperately needed social services to help clean the miserable bathroom, but also that she had an easel and painted these quirky primary-colored landscapes that I knew nothing about before. And though she couldn’t read them, she kept a huge bookcase of her dead parents’ books.

Of course, I live in a small community and also a culture where the distinction between a professional and personal relationship is hard to keep. Most shrinks keep  their offices as a front room in their homes – in fact, I don’t think I’ve ever been to one elsewhere. You can’t keep total neutrality anyway, because you’ll always have acquaintances in common, or at least I will because we both are in the medical community.

With my current shrink, there’s no real waiting room and a few times, when the client before me has run over, the shrink sits me down in his living room.

The last time that happened was WEIRD. The lights weren’t on because it was the middle of the day and the curtains were closed, so I just sort of stood there awkwardly in this semi-dark room. Then, all of the sudden, I realized his father was napping in an armchair in his underwear! I hadn’t even realized there was anyone in there until he said, “Please…sit down.” Scared the hell out of me. And now I know he’s disorderly, which is good – the newspaper is all over the place, etc. I wouldn’t like one of those sterile types.

And the shrinks’ offices I’ve been in are never very sterile. Well, my first counselor’s was because she was at the time working in an organization and it wasn’t really her office. But usually, their kids’ crap is strewn around, paintings by their kids and pictures on the wall. The bookshelves are filled with their personal books, not just the shrink journals. The current shrink’s couch always has these old, well-loved stuffed animals on it. I always wonder whose they are/were, or if they are there for patients to hug or something (he doesn’t see kids). There’s this old burlap stuffed dog that I want to pick one and hold sometimes, but I never would. I could never admit I want that simple childish comfort.

It’s not formal there at all – and in the summer I usually kick off my sandals and curl my feet under me, especially if I’m wearing a long dress. I always wonder always if this is weird, if it is going to be interpreted as some kind of behavior or other – possibly seductive, or dismissive of the seriousness of his profession. The truth is, I’m really short and most normal adult furniture leaves my legs hanging a little uncomfortably, so I always pull them up, even at the dinner table my knees curl up and I put my heels on the chair and eat over my knees.

There IS an element of hosting, or guest-host dynamics, like someone said on the original posts, but I think that’s ok. I always thought my ideal practice would be solo, out of my home…where I stop feeling like I have something to hide and people know that the doctor lives here. (Yes, that’s really me talking.)

On the other hand, I think that my shrink seeing me in my home would be an INCREDIBLY stressful experience. Not that there’s anything out of the ordinary about my home or anything that I want to hide (other than the lithium boxes, ha ha, which I leave out so I don’t forget to take it, but also panic that someone will drop in unexpectedly and see them). It’s always a mess, but a comfortable mess for me; there’s not filth everywhere or anything like that. It looks like the average apartment in this area, slightly messier. It’s warm and safe-feeling, I think. But I’m so guarded around him in general that it seems like that would be too revealing. My home is always my fortress and my retreat. I rarely invite people over, just because it’s my sanctuary. It’s where my books, my true lovers are, and I want to protect them, keep them private.

Also, I hate how the living room walls are adorned. There is one big picture hung in the wrong spot on the wall. It always bugs me as out of proportion. My partner does not know how to hang a picture.

But I digress. What I wanted to do with this post is ask everyone about their shrink’s office, or, for the few shrinks that read, about your office. What do you think about it all? Do you want the professional look or something personal? Ever been in a really weird office? Describe your shrink’s office in the comments, or on your site and leave a link to the post – all the bloody details and what you interpret from them. Maybe we’ll round them up and get a Shrink Rap post out of one of them on the subject too.

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16 Comments

  1. My therapist works alone – no receptionist. In the beginning I found it odd to walk into an empty room and be the only person there, and since she often ran a bit late, then I’d be worried that I’d shown up at the wrong time or she wasn’t going to see me (that improved as I became more comfortable with the relationship). The working office, inside, was comfortable but not “home-like”. I loved walking in there, but that’s because I loved seeing her.

    I took a psych elective on group therapy in med school, taught by a Freudian analyst in his office in Manhattan. He had a folding screen that walled off the rest of the apartment, and his office was classic analyst – even had a couch. I found that environment very unsettling, but then I really didn’t like the guy or the other student I was with or anything about the elective.

    I think what I’m trying to say is that I respond more strongly to the relationship than the office.

  2. I really don’t care much about the office, but would prefer it to be not too personal, I suppose, as that would be too distracting. I would not like to see photographs of a spouse and children and drawings by children and other reminders of a home life somewhere. I just like a nondescript office that could belong to anyone and could be anywhere, because to me it is the person that matters and who I seek the bond with. I don’t want to know too many personal things about the therapist either, I just want that person to be a professional I can talk to and only have that sort of relationship with him or her. The art on the walls doesn’t have to be stunning and the books on the book case don’t have to impress me. Those would all become interfering distractions and possibly give me too much information about that person. I am not there to become an acquaintance after all.

  3. […] S wrote an entry about psychiatrists’ offices, so I thought I would dedicate a small entry to that. […]

  4. Hi,

    Good to see you mention me on your blog. I feel complimented.

    My office has always be the more homely style than in big high rise professional style building.

    Cheers

    Tony

  5. Oh yeah, Jay, in this area it’s informal and no one has a receptionist. They all have you call their cell numbers for appointments or anything. I find this incredibly awkward. It always feels like I’m intruding, even though it’s perfectly normal around here. I didn’t even ask about the whole receptionist/waiting area stuff.

    The good woman counselor, when she got her own office, had it in an old Victorian home, where all the rooms had been turned into therapist offices. It was warm, with fluffy furniture and some books and maybe plants, but impersonal. The building was cool though.

  6. An adorable homely study with a fire and loads of knick knacks lying around the place. And books. Hundreds of books.

  7. At CAMHS 9child and adolecent mental health services) they have around ten interview rooms that all sessions take place in. They generally have around six of so chairs in and a few painting on the wall. I think they try to keep the rooms as minamalist as posibble as so many social workers/psychiatrists/ CPNs/therapists work out of the same building and all use the same rooms.

  8. I used to hate my shrink’s office, because it reminded me of a cluttered basement. Now I like it for exactly that reason, because it reminds me of just that – a cluttered basement. A couple of couches, a rolly office chair in the middle for him, ikea shelves, random office appliances… just randomness. But there’s this sense of “i’ve done this long enough that I don’t need a sterile office”, and the fact that he has kids tearing up his office several times a day (I did it at some point too) means that it’s just that – a kids’ shrink’s office.

    Honestly, I walk in there, and sink into the couch and just take my shoes off and let my hair down… Who cares what the room looks like – as long as I’m there and he’s there and the conversation’s flowing?

  9. Hi Sara,
    I cracked up when I read about you being surprised in a low lit room by your pdoc’s mostly naked, napping father…I think I would have fled the building….thanks for the very visual moment of levity.

    My pdoc’s office is in a hospital, but was just newly renovated. He is much like me in terms of order …organized chaos…When I used to work everyone couldn’t get over how messy my desk was, but I knew exactly where everything was. Actually his space has been a lot tidier recently.

    His place is pretty nondescript, with very few personal things in it….but what I love, part of what makes me feel really connected to him, is that when I walk in his office I see three things I gave him:
    1),a tiny 1.5 cm round blown glass ladybug that sits in the dirt of his office plant,
    2} a fossilized leaf that I choose to give him from my mom’s when she passed away (it represented to me how something so soft and flexible could make such an impression in something as hard and unmaleable as rock)
    3) and a book I could not resist buying for him when I was volunteering at the Shakespeare Festival…I literally judged and bought the book for its cover…(well actually its title): “Shakespeare’s Hard, but so is Life”…it was too perfect to pass up as a gift.

    I sometimes wonder if he puts away my things for his next appointment and pulls out things his next patient gave him for theirs. It makes the space seem personal to me.
    …aqua

  10. Heh, the one thing I keep getting is that everyone seems to care more about their shrink than the office. Not me, I guess. Or if not the office specifically, than something.

    kahless – nice description, but is it good for you like that? What do you think?

    Rach – a chair in the middle for him sounds weird. Especially rolly. Like he’s going to roll right over. I think that might make me feel invaded. I’ve only seen them against the wall more or less, equidistant from how you are. Is it like he’s hovering there in the middle of the room?

    coloredmind – that sounds…well, really institutional and depressing. I imagine it looking like these bland empty government furniture rooms at our hospital.

    And Aqua – yes, I also got a good laugh out of that scene in the dark room. It was so surreal, I thought to myself, holy shit, I MUST write this down, and when I write my book, this incident is going in it. And I was surprised to hear your guy’s office is in a hospital. It always seems so homey and safe when you describe it. I was sure it must be in a house or something. Interesting. And as a doc myself, I seriously doubt he changes the stuff around for each patient! I always put stuff patients give me (if it isn’t personal) wherever I’m working if I have a work space for a while.

  11. Sar, he kinda just hangs out in the middle of the room… doesn’t roll around, but I guess the chair concept works, as opposed to having a stiff chair… In thinking about it, it makes sense, because if he rolls the chair over to the desk, which is pushed against one wall, he has one big open space in the middle… so kids can have tantrums, or whatever.

    But no, there’s definitely a few feet of space – enough for me to stretch my feet out, and him to stretch his feet out, with room left over.

  12. And it’s interesting how much a physical space can have an influence on us, huh??? I remember the first shrink I ever went to – his office was so stiff and uninviting – much like his personality. I don’t think I lasted more than 3 sessions with him. I wouldn’t open my mouth.

  13. Honestly I dont know.
    Made me feel more comfortable which is a good thing perhaps as my defenses were less enabled; less on my guard? Maybe.

  14. My last, best psychiatrist who did therapy (f i v e years ago, in another state) had a wonderful office…for my taste anyhow. Lots of family pictures (mostly of when Eli, Ezra and Ethan , yes, of course i knew their names) were younger, two beautiful art deco scriptural framed prints from Israel, r e a l plants , a Menroah he put out for Hanukkah and it just kind of stayed, knick knacks, a picture of the dog-a golden retriver (who hid in the tub during thunder storms)….see what i’m getting at here…he wasn’t afraid to tell about himself, through his office or during therapy. i need someone who is at least a little open about themselves…i can’t deal with a “flat affect-tabula rusa”. i am alone enough, i need interaction. Ugh, i am sooo “needy”! i also had a terrific psychiatric resident for therapy, who, while we met in various offices was not afraid to share a little about himself…that’s not to say it was all fun and games, i did hard work with him…and i miss him desperately…and will think always of the “cat-o-lantern” he makes every Halloween!

  15. That one sounds really nice.

    And speaking of, I think I’d quit a shrink who had fake plants.

  16. I HATE my therapists office! It makes me wildly uncomfortable and I find it hard to be there. This therapist does see children… and it always looks as if the previous clients toys are scattered about, I feel like I’m still seeing my pediatrician when I go there. Too old for the room and totally out of place.


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