From Psychology Today: “In my first week as a psychiatry faculty member, an advanced psychiatry resident—I’ll call her Dr. G—staffed a case with me. That’s medical speak for discussing a patient with a teacher. Dr. G gave me some demographic information, then began listing the medications she was prescribing.
‘Hold on,’ I said. ‘What are we treating her for?’
‘How do you understand her anxiety?’
Dr. G cocked her head to the side with a blank, non-comprehending look. I rephrased. ‘What do you think is making your patient anxious?’
She cocked her head to the other side.
‘What is causing her anxiety?’
Dr. G pondered, then brightened. ‘She has generalized anxiety disorder.’
‘Generalized anxiety disorder is not the cause of anxiety,’ I explained. ‘That is just the label we use to describe it.’
Another blank look. I tried a different tack. ‘What do you think is going on psychologically?’
‘I don’t think it’s psychological, I think it’s biological.’
‘Okay, that’s a start,’ I said. ‘Tell me why you think that.’
‘Her mother was anxious.’
‘This means your patient’s anxiety is biological?’
It was my turn to cock my head.
‘Let’s try a thought experiment. Suppose your patient was adopted at birth and is not biologically related to the mother who raised her. Do you think an anxious mother, who is continually communicating that the world is unsafe, could make a child anxious?’
‘I never thought about it that way.’
I suppressed a momentary urge to bang my head against the cinderblock wall. Then I signed Dr. G’s treatment plan and hoped I had planted at least a seed of curiosity.”