During our psychiatry residency, Chuck and I ran a weekly psychotherapy group supervised by an attending psychiatrist who was highly skilled in group psychotherapy.
After the end of each session, we would meet with the attending psychiatrist and analyze everything that transpired in minute detail. One question she frequently asked was: "What was the process?"
Not "What was the content?" i.e. what was said. Chuck and I would look blankly at each other, or down at the floor and try to think of a smart, and hopefully accurate, response.
Content and process are the yin and yang of any successful treatment. This week I found myself learning this lesson once again in my daily work with patients. Read on to learn more about what I mean.
Have a beautiful week!
Don't Stuff a Size 14 Illness into a Size 7 Treatment
If it's not going to fit
then it's not going to work
Imagine a surgeon who has completed the preparatory work for extensive surgery and is deep in the midst of a complicated procedure.
A family member interrupts the surgery and announces, "This procedure needs to be completed in half the time with half the staff. I can't pay for the whole operation but expect you to have the same outcome."
Ridiculous, right?
What about a size 14 girl forcing herself into a size 7 dress because she likes it and wants to be a size 7. How well will the dress fit her?
Really?! Okay, you're wondering, "what's the point, Dr. Lee?"
Well, in my psychiatric work, sometimes people only value the content of healing and ignore the process of healing. That means they believe that all they have to do is take some supplements and voilà, they will miraculously be able to withdraw from their medications with ease.
They don't understand that in order for the nutritional regimen (a small part of the content of treatment) to lead to a successful medication withdrawal outcome, there has to be a process or method that manages the healing.
This requires weekly care of the whole person, not just their biological health, within the context of a respectful, therapeutic relationship.
When I am being told that I must change my approach and reduce my follow-ups from weekly to every other week in the midst of treatment, it is as if the two scenarios with the surgeon and the size 14 girl are both happening in my office, but just at an abstract, thought level.
I was placed in a similar situation twice over the past two weeks. In the past, I tried to stuff the size 14 girl into a size 7 dress or tried to finish the surgery with half the staff in half the time.
This past week, a mother informed me that I must see her daughter every other week, not once a week (she knew before starting treatment that once per week would be the proper follow-up frequency.)
She announced it casually and exuded a sense of entitlement. She knew what she was expecting from me. She was a nurse, after all.
My response was "No, I will not do it." The mother became furious, yelling at me and accusing me of power plays. Finally, she ended by calling me a "hustler," and telling me to "go away," before she hung up on me.
Not only did her verbal abuse fail to change my decision. I wrote her a short termination letter that day.
On the other hand, another patient I have been working with has been suffering severely the past several weeks. We are working together as hard as we can to help her.
Two weeks ago, she said, "Dr. Lee, I have run out of money. I will need to see you for half an hour rather than an hour each week." She said it with dignity, fearful but accepting of the outcome of this cut in treatment.
It was clear that she needed more than half an hour per week. Though she didn't ask for it, I felt inspired to offer her treatment for half the cost so that we can continue to have the time we needed to help her improve. She was so grateful, she burst into tears. It was a happy, poignant moment for both of us.
I continued to mull over her condition day and night. I provided extra time during her session, did extra energy testing between sessions, and did extra energy work for her in the evenings, hoping for a solution and eventual resolution.
Over this past week, I discovered two interventions that I hope will help improve her health. One intervention came to me the moment I woke up at 5:00 a.m. on Saturday.
With additional research and energy testing, by 7 a.m. Saturday morning, I was able to recommend a change in her supplement regimen that I hoped would resolve her underlying issues. She immediately followed through with the additional change.
Through any challenging hardship, the process that leads to successful outcomes requires a trusting partnership between people. We cannot predict the outcome of her treatment, but there is only one path that can possibly lead to a successful outcome, and we are braving it together.
The healing journey isn't just about the what, but also about the how. It's not about the money. It's not about the supplements. It's about trust, love, faith, respect, honor, and courage. It's about relationships.
Life can be divided into content and process. They are the yin and yang of life. If you prioritize the process, the content will follow.
Hopefully, these insights are helpful.
The Holistic Psychiatrist Podcast (Ep. 55, 56, 57):
1st Anniversary Special: The Heroes' Journey
Click here to listen to Part 1
Click here to listen to Part 2
Click here to listen to Part 3
Be sure to subscribe!
For the first anniversary of The Holistic Psychiatrist Podcast, I want to honor the outstanding people I've encountered in my holistic psychiatric practice.
These individuals (patients and a mother of a patient) have shown true grit and courage when facing the challenges of mental illness. I admire them and have grown from knowing them.
In The Heroes' Journey parts 1-3, we will enjoy, for the first time, an extraordinary panel of six participants (Allyson, Ana, Jack, Justin, Peter, and Tanya) meeting together to share their personal hero’s and heroine’s journeys.
These strong, courageous, and intelligent individuals inspire us as they share their poignant stories and experiences during the three phases of the heroes' journey:
Part 1) The Departure into the Unknown—the initial encounter with formidable challenges, intense suffering, and unexpected weaknesses.
Part 2) The Initiation—navigating new territory, overcoming obstacles, developing discipline, learning lessons, and gaining skills.
Part 3) The Return—coming back with gifts from the healing process: positive rewards, transformations, and outcomes.
I hope The Heroes' Journey Series will strengthen you along your own hero's or heroine's journey.
Click here to listen to all of The Holistic Psychiatrist Podcast episodes.