Patient, Interrupted

There are strange doctors in every specialty. Offbeat cardiologists. Creepy podiatrists. Sketchy dermatologists.

Then there’s almost every psychiatrist I’ve seen.

Socially awkward? Speak incredibly soft with minimal emotion? Eye contact not your thing? After you’ve exhausted your first, second and third through sixth choices, consider a career in psychiatry.

I don’t know the extent of French psychiatrist Jacques Lacan’s quirks, but when he introduced the variable-length session his colleagues must have thought him batty.

Analysts typically bill for a “50-minute hour,” which affords them a 10-minute break between sessions to maintain their own sanity. Lacan found this format too predictable. A depressed patient aware of the clock might limit herself to less pressing concerns in the interest of time. An obsessive patient attuned to patterns might prepare in advance an outline of his session, a classic defense mechanism.

To combat complacency and open possibilities for unexpected associations, Lacan liked to end discussion at any moment. He interrupted patients after an intriguing thought or provocative turn of phrase, inviting them to process these moments between sessions.

Maybe you’d see Lacan five minutes this week, 47 the next and 18 the week after that. Surprise was guaranteed.

It’s possible that Lacan’s own psychology informed his unorthodox approach. Rumor has it that an examiner interrupted Lacan near the end of his thesis defense, cutting him off mid-sentence. Did he feel compelled to repeat this experience with patients in an effort to regain control? If so, it didn’t work. Lacan’s methods led to his expulsion from the International Psychoanalytic Association.

I admire Lacan’s creativity but today the variable-length session would drive insurance companies and hospitals nuts. Imagine the paperwork. The fluctuating co-pays. If I were in and out of the office, who would validate my parking?

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1 Comment

Filed under Philosophy

One response to “Patient, Interrupted

  1. I don’t think doctors hold the monopoly on “weird”! They are dispersed in society pretty randomly but we just don’t hold our lives in other random people’s hands…

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