Psychiatrists' Children Often Find Parent's Profession a Mystery

I knew I had walked into the middle of something that morning when I saw my co-residents huddled over a computer. It was the Matt Lauer–Tom Cruise interview transcript. Although Tom Cruise still apparently had many women at“ hello”—his often-quoted line from “Jerry Maguire”—he had lost me somewhere between break-ups with Nicole and Penelope. When I got to the line, “Psychiatry is a pseudoscience,” I had read enough.

Some people say that psychiatry is one of the most misunderstood fields in medicine. But what I have learned is that even family members of psychiatrists fall prey to this misunderstanding. A joke I once heard involved a 10-year-old boy at a party who was asked “What does your father do for a living?” “I'm not sure,” he responded. “He goes into his office with pretty women, and comes out with a lot of cash in his hands.” The point of the joke was, of course, that his father turned out to be a Manhattan psychiatrist.

At the last APA annual meeting, I had the honor of presenting at a workshop titled Children of Psychiatrists, led by Dr. Michelle Riba, who was completing her term as APA president, and Dr. Leah Dickstein. It was an opportunity for me explore why the field of psychiatry is such an enigma for so many, particularly children of psychiatrists.

I stepped into the conference room and in front of an audience of about 100. There was little time for tachycardia, sweaty palms, or other signs of impending doom. I began with an anecdote that my father had shared with me. As he entered medical school, he envisioned himself a surgeon, but later decided to enter psychiatry. A senior faculty member responded, Satish, you don't have tuberculosis, and you're not mentally ill, so why would you want to go into psychiatry? Well, despite being told in that encounter that psychiatry was meant only for the disabled, my father entered psychiatry that year and never looked back. What is it that is so esoteric and even romantic about psychiatry, especially for children of psychiatrists? My hypotheses: 1) There are no tools of the trade children can hold in their hands, 2) Confidentiality concerns further obscure what little information children do have, 3) Many individuals lack information and understanding about mental illness. Let me further explain these hypotheses.

There are no tools of the trade. Cardiologists have stethoscopes and EKG machines. What do psychiatrists have? In Thomas Maeders's Children of Psychiatrists and Psychotherapists, he cites a vignette of a woman who describes an early experience in which she was told to bring something from her father's job to show and tell. She recalls thinking that her classmates had fathers with “real” jobs—the kids brought in drain pipes, circuit breakers, and blueprints. Her father gave her a pad of yellow legal paper, a pen, and a reflex hammer. “I knew that he didn't even use the hammer and was just trying to make himself seem important,” the woman recounted. “I decided that my father didn't do anything at all.” In psychiatry, there is no process that children can watch, no tools, no product. There is something intangible about psychotherapy for most of us children of psychiatrists, and we are left to wonder what exactly happens behind those closed office doors?

Issues of confidentiality and privacy make it difficult for psychiatrist parents to talk about specifics with their kids. Also, as children of psychiatrists visiting our parents at work, we often find it to be bland. Family pictures are absent. There are often special rules for home offices—children must be quiet when nearby. A couch replaces the more familiar examination table.

Stigma and misunderstanding present as additional barriers to understanding psychiatry. One of my supervisors, while taking her son to school, ran into a patient of hers. The child was surprised to find out that the woman was a patient. But mom, she looked so normal, the child responded. Many children—and not just those of psychiatrists—have the misperception that all patients with mental illness are locked away in wards and engage in bizarre behavior; they fail to see them as people with jobs and families—as people seeking help for an illness.

As my talk came to a conclusion on that hot Atlanta morning, I was glad I decided to participate, sweaty palms and all. I learned that for parents who are psychiatrists, communicating with one's child about mental health is extremely helpful in the demystification process. And I found that one of the most important things a parent can pass on to his or her child is their own passion in life. So even though your child may not become a psychiatrist, at least he or she will know that you gave them that gift. ▪