Psychiatr News November 18, 2005
Volume 40, Number 22, page 10
© 2005 American Psychiatric Association

Viewpoint

Psychiatrists' Children Often Find Parent's Profession
a Mystery

Sudeepta Varma, M.D.
Sudeepta Varma, M.D., is a PGY-3 psychiatry resident
at New York University School of Medicine.

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.



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