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Friday, September 23, 2022

Character Description 2: The Doctor as an Interpreter: A blog by Warren Bull


Image from Bruno Rodrigues on Unsplash

Character Description 2: The Doctor as an Interpreter: A blog by Warren Bull

Let’s suppose that your character is a shrink, i.e., a mental health professional. The professions come in a variety of flavors with different training and approaches. Nurses, counselors, clergy, social workers, clinical psychologists, psychiatrists, and so forth. All need to understand what the person on the other side of the desk is seeking help with. All need to diagnose. How does a writer show the task?  It helps to know what the task entails.

Diagnosis in mental health is tricky. When I was a practicing psychologist, even before I met with a new client, I was safe almost all of the time assuming the client would tell me he or she was depressed, anxious, and had a history of experiencing trauma. There are books based on extensive research that might lead you to believe you could diagnose a person’s problems by going down the list of symptoms in the categories for diagnoses inside the book. It looks like a menu. Two items from column A and three items from Column B means an order of steamed broccoli and shrimp Lo Mein which rules out the option of snow peas with beef fried rice.

Unfortunately, the patient sitting in front of your character has not read the books or taken the same courses as you. He or she might complain of “nerves” or say the problem is like a particular country song or like what happened to a specific character in a soap opera. 

It is the character’s job to translate the story the patient tells into the dialect of psychiatry. However, the categories that science likes to pretend do not overlap with other categories were developed in studies that carefully excluded “confounding variables.” That is, in order to study problems related to past trauma, researchers screened out subjects with side issues like substance abuse, brain trauma, and so forth. Fair enough.  To research on the effect of past trauma scientists want to avoid subjects whose issues might be caused by events unrelated to past trauma. Great, excellent, wonderful except it is awkward telling patients, “I would know exactly how to help you if you had not been injured in that gas pipe explosion and if you didn’t use cocaine.”

Your character needs to listen to a client’s story with the understanding that it makes sense to the client, while keeping an open mind about what the words mean in diagnostic language. “We were like all Italian (Irish, French, Cajun, Southern Baptist Black, etc.) families.” Does that mean friendly, loud, heavy on the alcohol, silent, close, distant, or something else entirely? Your character needs to figure it out.

Just to make things interesting, as the main character in the television show “House” used to proclaim, “Everybody lies.” I would be a bit more tactful but I essentially agree. Patients want to present themselves in the best light possible. They shade their answers to make themselves look positive. They subtly ask for permission to discuss embarrassing concerns and willingly avoid topics that elicit signs of disapproval or disinterest.  

You can make your character more believable by showing their sensitivity, or lack thereof, to the stories their patents present.


Margaret S. Hamilton said...

interesting! Thanks for your perspective.

Margaret S. Hamilton said...
This comment has been removed by the author.
Jim Jackson said...

And even if characters aren't doctors, how they listen to other characters shows a lot about themselves.

Marilyn Levinson said...

Great analogy, Warren. That line from "House" always stuck with me.