Are they all a little crazy to begin with? And do psychiatric residencies turn out therapists who tend to be arrogant and insular? According to Light, a research sociologist at the Center for Biomedical Education (CCNY), there are serious flaws in the structure of many training programs, and his detailed study of one such program--Mass. Mental Health Center in the late 60's--raises questions not only about the process of becoming a psychiatrist but about the slant of the profession as well. Light had access to important places (ward meetings, case conferences, supervision sessions); he also listened to residents griping and groaning as he observed their rites of passage. Anxious new residents, face-to-face with the sickest patients, learn management-tasks first, then move on to therapy, swiftly discovering that their own counter transference is a chronic ailment. They try out different techniques, modeling themselves on a few supervisors, and evolve a professional identity in a somewhat haphazard fashion: ""being comfortable and being effective become synonymous."" Light contends that the residency program has many soft spots, including vague selection criteria and a psychoanalytic bias that favors therapy over drugs (despite genuine pharmacological advances) and ignores critical issues--racism, sexism, community psychiatry. Furthermore, psychiatrists learn to take credit for patient improvement and to fault circumstances for treatment failures--a tactic shared by other professionals. Light understands the therapeutic relationship better than most outsiders, and as a sociologist inspired by heavyweights (Goffman, Renee Fox), he defines his terms clearly (e.g., role-learning vs. socialization) and systematically states his opposition to other modes of investigation. But his study has several soft spots of its own, including an ambiguous allusion to psychiatrists' sexual involvement with their patients, no follow-up showing how the residents studied perform now, and few signs of competence anywhere along these hospital corridors. By concentrating on the first year, he excludes relevant data which might alter his conclusions. Nonetheless, he offers many insights in this even-toned if ultimately unfriendly characterization.
Pub Date: April 28, 1980
Page Count: -
Review Posted Online: N/A
Kirkus Reviews Issue: April 1, 1980
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