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Introspections   |    
The Grand Inquisitor
Richard G. Druss, M.D.
Am J Psychiatry 2004;161:1765-1766. doi:10.1176/appi.ajp.161.10.1765
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The 1960s were the heyday of psychoanalysis in America. All my friends and colleagues, even some who would later enjoy distinguished careers in basic research or administration, enrolled in analytic training. I applied to the Columbia Institute in New York City. There were the usual forms and letters of recommendation, but the heart of the application process was four probing interviews, three with the admissions committee and a final one with the director. I was asymptomatic, felt well, and had never visited the office of a psychiatrist before as a patient, so I felt like a man who had volunteered to undergo four elective computerized tomography scans of his head: What incurable tumor lying hidden in the deep recesses of my brain would be revealed by this process?

My first interview was scheduled with a man I will call Dr. Vlad Nosferatu, an expert in the psychoanalysis of schizophrenic disorders. I recall this unpleasant experience in exquisite detail and quote it almost verbatim.

"What were you like as an adolescent?" he began. He had offered no hello or handshake. Right to business.

"I was funny, had lots of friends, and was thin."

"How thin?"

"Well," I said, trying to loosen things up a bit with an old line, "People said that when I drank a glass of tomato juice I looked like a thermometer."

But no smile was forthcoming in response. If anything, he appeared a bit annoyed as he then asked, "Did you ever not eat for 2 or 3 days in a row to stay thin?"

"No, no," I said, getting really serious, "Actually I filled out quite a bit once I got to ­college."

"Filled out?" he replied. "Filledout what? I’m not sure I understand." Long pause. "Do people ever tell you that you use words in an odd way?"

"Not really," I stammered. (He thinks I’m crazy, I thought.)

"You use a lot of neologisms." (More precisely, he thinks I’m schizophrenic.)

"I’ll try not to."

"When did you first have sex?" he asked.

"It was during my first year at college."

"That’s a bit late, isn’t it?" insisted Nosferatu.

"It was about average for my cultural group at that time." (He thinks I have an infantile, dependent personality.)

"Was it with a man or a woman?"

"A woman," I squeaked. (He is sure I am a "latent" homosexual.)

My voice began to fail me as I became angrier and angrier. Nosferatu kept saying he had trouble following my line of thought. (He’s noted an obvious thought disorder.)

The questioning lasted the better part of 2 hours. His blank face never changed expression. And then, without salutation, he dismissed me.

I remember walking out of his office dazed and blinking in the morning sunlight. Should I sign myself in to a locked ward, I wondered? I was steaming by the time I got home for dinner. And I was discouraged. My wife asked what Dr. Nosferatu was like. "He’s a prick, plain and simple. I’m withdrawing my application."

Quite sensibly, as usual, my wife suggested I keep my other interview appointments before I made such a rash decision. Fortunately, I followed her advice.

My second and third interviews were with Dr. Arnold Cooper and the late Dr. Henriette Klein, both fine psychiatrists and psychoanalysts who later became personal friends. We discussed the same material, but as one colleague to another instead of as inquisitor to his victim.

My final interview was with the Institute director. Dr. George S. Goldman greeted me warmly—he seemed wise, benign, and unflappable. There was one exchange that stuck in my mind. At one point he asked me how I was feeling right then and there. I said, "Pretty good, Dr. Goldman." He said, "Then why are your knuckles white from gripping the chair arms?" I looked down at my hands, realized they were gripping the chair arms, and quickly unclenched them.

"Wow," I said. "I feel like Donald Duck in one of the cartoons where a bulb lights up over Donald’s head to signify ‘insight’." (This man is a genius for sure, I thought.) I was accepted shortly thereafter and had a wonderful experience.

During the last 40 years, the so-called "stress" interview of which I was but one victim has been shown to predict future performance about as well as one’s astrologic sign. It is no longer used in the admission process of analytic institutes, residency training programs, or reputable centers of higher learning. Young people today just wouldn’t submit so passively, and any budding Nosferatu would be summarily dismissed.

But long ago, during my own training, I took holy vows that I would never interview any applicant (and I have seen many) or supervise any trainee (and I have taught many) or treat any patient with such sadism and discourtesy.

I think I have kept my vows.

Address reprint requests to Dr. Druss, 180 East End Ave., New York, NY 10128.

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