There are many enjoyable aspects to practicing psychiatry. Humor, unfortunately, is not usually one of them. If psychiatrists are not careful, the seriousness of what we do can deplete our emotional energy, and our work can become depressing. Also, psychiatric patients are people, too. Even when they are in a melancholic state, they can still have a sliver of humor left. And, properly-timed humor can be therapeutic, right? So, is it appropriate for psychiatrists and other mental health professionals to joke with our patients? If so, when?
A psychiatric resident wrote a NY Times article about this topic. Interestingly he mentions that when he was an intern on the internal medicine service, he regularly joked with his patients. But, when he started working on the psychiatric service, the humor stopped. He not only felt uncomfortable with the idea of joking with his new patients, but he squirmed when they attempted to joke with him. Ultimately he found a way to joke with a delusional woman in a manner that allowed him to establish enough rapport with her so that she readily gave him her history.
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Imagine that as a child you thought you had been born in the body of the wrong gender. If you were biologically male, in your mind you really thought of yourself as female. Likewise, if you were born in a girl’s body, you thought that you were actually a boy.
Yes, you were probably more interested in children’s role-playing games more often associated with the opposite gender as well, but the issue went much deeper than that. It was your core identity that was at stake. You knew that you were the other sex, at least in all ways except for the reproductive organs of your body.
You felt this way during childhood, but nobody seemed to understand or accept this about you. But you were dressed in the clothing of your biological gender and expected to participate in the activities stereotypically associated with it as well. Imagine that as your body matured in adolescence, you hated your
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