I often get the same question/response from people concerning visiting my office. People always think that we psychiatrists have couches all over our offices, and that everybody that comes in has to lay on one of them and tell us about their childhood.

Well yeah, you do have to come into the office, but that is where the story ends. Psychiatrists are trained physicians who, while during their med school training, have delivered babies, been involved in major surgeries and worked in the offices of Family practice physicians. Our view of psychiatry is largely based on the medical model of illness, much the same as any physical illness. Now there are big differences in how a psychiatrist may approach a patient as opposed to a physician in another specialty. The biggest difference lies in the core of information we are seeking. As with a physical illness, doctors will more then likely want to know how the state of the body and mind is, and how the mind is effects the mind. However, Psychiatrists may flip the scrip and explore the shape the mind is in, and how the mind is effecting the person’s body. Now before everybody gets upset, I am not saying that psychiatrists don’t care about physical health and other physicians don’t care about the psychological and emotional health of their patients. The specialties overlap greatly. But for the sake of this discussion we are going to split that fine hair and view this topic solely from a one sided perspective in order to try to convey in black and white the very gray area in which psychiatrist work.

Now back to my office. When you arrive you will be asked to fill out a short questionnaire, and then proceed into my office where we will discuss the reasons you decided to seek help. This is often where many people get tripped up because they believe that this is the point where they tell me about all the things that happened in their childhood. The reality is that for a great majority of the adults I see with a diagnosable disorder, what went on in their childhood has little connection to the present illness. Now that’s not to say that the root of many problems in our emotional health don’t have a basis in early development, but the issues in people’s lives I deal with daily usually are more recent then that. Depression, anxiety and various other disorders, like physical illnesses, can be recent and short-lived with treatment or life long and require treatment over the life of the person.

After a review of the patient’s medical history, we will review any past psychiatric history that the patient may have, and then we discuss what the patient’s most recent diagnosis may be and what the best treatment options are. After deciding on a plan of action, a treatment plan is discussed, and medications are given if needed. Lastly, payment is collected and follow up appointments are arranged, and your hour-long ordeal is now at an end.

The above description is a synopsis of what typically occurs in a first visit to my office. These events can be very different depending on the issues at hand and the type of illness the patient is presenting me with. Though the scenario may vary from patient to patient and from Doctor to Doctor the notion that all Psychiatrists have everybody lay down on couches and read their minds is somewhat amusing. At times, in some social settings, after talking with someone for a little, the topic of professions comes up, and it is amazing to see how many people actually become very nervous about talking to or around you after they find out that you are a psychiatrist. Many people do indeed believe you are analyzing them as they speak. While this often is amusing it does belie a very important fact that while most people understand true psychopathology. The problem comes in when misconceptions and prejudices fill the voids of our understanding.

So then let us not let our fears and misconceptions of Psychiatry prevent us from seeking help if there is a problem. Just make an appointment and come on in and have a seat and let’s see what we can do to make your life better.

Edward Boyd Freeman, M.D. is Medical Director/Director of Psychiatric Services of Family Medical Center. He is also Medical Director and President/CEO of Manfred & Associates, Professional Consults in Houston, Texas.