Shirah Vollmer MD

The Musings of Dr. Vollmer

Dual Relationships

Posted by Dr. Vollmer on July 19, 2011

   July kicks off my month of meeting new Family Medicine Residents, Child Psychiatry Fellows and Adult Psychiatry Residents. My role differs in these three arenas, yet I feel similarly in that I have this sense that we are creating new bonds. Sure, I am their “teacher” and sure, there are boundaries that I must be very conscious about, but they are no where near the boundaries involved in a therapeutic relationship. I have reporting responsibilities with my students such that they know that I am letting their program director know if I encounter any problems or concerns. Still, as a psychiatrist-teacher, I feel it is important to get to know my students. Part of this desire is selfish. My job is more fun when I know who I am teaching. Part of this desire is also helpful. If they trust me as a person, they are more likely to be interested in what I have to say.

    Jerry, twenty-eight, fresh out of medical school, comes to my office to learn about psychopharmacology. As we begin to chat, he tells me, with tears in his eyes, that his mom passed away two years ago in a car accident. “You know, I don’t know how to deal with it. It is just too hard for me.” He says, not really asking for my help, but wanting me to know that he is suffering terribly. “Have you thought about going to therapy?” I ask, knowing that he knew that I was going to inquire about that. “Oh yea. I have been to therapy but it did not help.” Jerry says, looking at me as if to say, my mom died and therapy can’t make that better. We continue to talk about what his mom was like. As we do that, we move into the details of her death: how he found out, what the funeral was like, how his friends rallied around him. I feel very sad for him, but I also need to teach him about medicines for the mind. Of course, I am thinking that psychotropics might help Jerry, but since I am not his doctor, it is not really my place to say that. Perhaps he will think about it as we discuss the indications for the SSRIs. We slowly transition to the didactic part of our time together, but it seems clear to both of us that we are really sad.  Yet, as the time went on, and it was time to go, Jerry perked up. He seemed relieved to get his feelings out. We had a good connection, I felt. We will see how it goes next week. I am optimistic and sad at the same time.

4 Responses to “Dual Relationships”

  1. Shelly said

    Do you need to “get to know” each of your students individually like this, or only if students ask to see you? Or is it like supervision, and you are the supervising teacher? Do psychiatric residents have to undergo therapy or only those who will become psychoanalysts?

    • I enjoy getting to know my students, so I take it upon myself. I do a combination of teaching and supervision. Psychiatric residents do not have to undergo therapy, but many choose to.

  2. Annette Jackson said

    Excellent response by Dr. Vollmert is good to know that is interested in learning about its residents.

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