Couch Sessions

“I think couches are necessary.”

(They’re optional, and because of that, I would definitely want one in my clinic.)

This was my thought when one of the consultants at the round-table discussion asked if we psychiatrists still had hour-long consults and couches in our clinics…

The senior psychiatrist said that it wasn’t necessary anymore, and that real consults did not take as long. I, being the junior, merely nodded, as the question was addressed to him, but being the idealistic young graduate that I was, I knew in my heart that I definitely wanted to have one. 🙂

Granted I do not know much yet about the nitty gritty of private practice yet, I do know that I wanted a place or a space where someone wanted to stay to talk about their troubles, and express themselves and correspondingly, in the same way, I wanted to have a conducive environment where I was comfortable enough in assessing someone’s case.

The Psychoanalyst's Couch. (not mine).
The Psychoanalyst’s Couch. (not mine).

The image of the couch connoted hours and hours of free association as in the times of Freud, where one could spew forth thoughts and musings while a therapist would listen and take notes. More often than not, this is what people think of when they hear the word “Psychiatry” (or the other thing).

I suppose it’s a matter of choice…if I were to empathize with a troubled individual, and ask myself, “If I were a patient, what would I like?”

Well, for starters, I’d want to be able to talk in a calming atmosphere, somewhere without a lot of fuss and noise, or where I could just sit and talk and not be pressured to talk or behave as “psych patients” would do. I’d like to be able to talk freely, without worrying about whether what I would say to my psychiatrist would be tomorrow’s gossip fodder. Confidentiality was a big thing.

Also, comfort. 🙂

I do recall before, with my table and chairs set-up, talking to someone with a family problem. As he/she was talking more and more about the problem, I noticed that he/she had begun to lean back and then almost lost himself/herself in her narrative. I had to suppress a smile when I noticed that he/she had already started to put her feet up on the chair opposite his/hers. Or, if it was particularly nerve-wracking, or distressing, people would need to feel comfortable enough to hold onto something.


But that’s just me, though. I’ve never been a patient myself, but when I was a sophomore in training, I had a supervisor who had such a comfortable clinic. When we discussed our cases, he’d have me pick my seat on any of the couches, and he would take a different one somewhere else in the room, and we’d talk about the case that way. And, because I could see the books nearby, I felt free to ask him about the titles and to browse about Psychiatry textbooks, handbooks, novels, etc. It was more conducive to learning.

However, I also found learning better when I sat on the table perpendicular to my teacher, so I could see her face to face and talk about the case at close range.

I think I’m going to apply that in my clinic and future practice. There’s the option to use the couch, and there’s also the option to sit comfortably on the chair near the table. Either way, it can be an empowering thing for the patient to be able to decide how the problem will be tackled the problem. I think that having the person choose how he wants to start is one of the steps to achieving an impact with rapport and psychotherapy. Also, I want therapy session to be something they will look forward to because they know that the work they put in of coming to the clinic will help them recover.

I was provided with a nice black corner couch for starters, with throw pillows in black and while and silver accents. I’m getting a full couch soon, but for now, at least these two options (i.e. couch or table) will be available for the patient.

These were my picks for clinic couch when the next time I can get them, though. 🙂

(Photos aren’t mine…got them from random sites online, and Pinterest.)

birmingham-maple-clinic-office-1 black and grey  circle pillows couch  photo8  white

The personal narrative

I got this idea after reading Vivian Gornick’s “The Situation and the Story: The Art of Personal Narrative.” I’m starting to explore this avenue.”

And I quote: “The writing we call personal narrative is written by people who, in essence, are imagining only themselves; in relation to the subject in hand. The connection is an intimate one; in fact, it is critical. Out of the raw material of a writer’s own undisguised being a narrator is fashioned whose existence on the page is integral to the tale being told. This narrator becomes a persona. Its tone of voice, its angle of vision, the rhythm of its sentences, what it selects to observe and what to ignore are chosen to serve the subject; yet the same time the way the narrator – or that persona – sees things is, to the large degree, the thing being seen.

“…To fashion a persona out of one’s own undisguised self is no easy thing…The unsurrogated [NB: without the “trappings” of fiction] narrator has the monumental task of transforming low-level self-interest into the kind of detached empathy required of a piece of writing that is to be of value to the disinterested reader.”

It is very much like journal writing in a sense that there is narration, but the voice, the voice should be strong and unique. 🙂

It’s a riveting book and is very well-written. I was entranced, and inspired.

(The rest of the book is here…)

What’s your favorite form of writing?

A Farewell to McCharming

Derek Shepherd, the man who was made of the stuff of dreams…died today.

As one of the most charismatic leading men in the history of television, he deserves a space in my freedom space. He was so well-made, so perfect…and he always said the best things (at the best times) ever. And those lines? They were just what any girl would want to hear.

The modern day Prince Charming that he was, he was always rescuing people and saving lives and what not. And because of this,  I even believe he was many modern women’s idea of a Knight in Shining Armor (that every boy had to live up to). And he had to be a Neurosurgeon to top it off.


Ahh, that archetype, it is much loved by all, and for good reason.

Surgeons have an unmistakably enigmatic allure to them, I think that’s what draws women to them. They deal with life or death matters (especially more so on TV), they get things done, they have skill sets that your regular average Joe can only dream about. People tend to gravitate towards that.


They also have nice hands.

I remember at my training hospital, I had a crush on one surgery resident, who had such hands. He was doing an umbilical cut down and he was working on a baby. I was done with my patient in the emergency room, so I could not help but linger in the emergency room a few feet away. Ah,as those long graceful fingers worked speedily, and I was mesmerized. I had a silly smile on my face while looking on, I believe, and I distinctly remember wanting to write about his hands while I was watching.  When he was done, he and his coresident sat down on the chair in the opposite side of the room, chatting as if it was a regular thing to do on a daily basis. I remembered resisting the urge to put my chin on my hand and stare dreamily at his hands. (Or at him. Haha)

Surgery residents would make great trophy boyfriends, in the same way as Dermatology residents would make great trophy girlfriends. And neither of them can help it. It’s that swagger, that “it” factor, that “je nes sais quoi” that is culturally associated with their specialty choice.

Or maybe it’s that unmistakable self-confidence that seems to sweat out of every pore? They do have that…and they do know it. (And they somehow make you feel safe. Like they could take anyone in a hospital brawl…if it ever happened.)

Not every surgeon is like McDreamy, of course, and there’s the rub. McDreamy is THE dude. (Why did he have to be so perfect? He’d make any girl swoon, because it was inherent in his made-up character.) His character appealed to me, but only as an ideal. There’s no way there’s a man who is THAT perfect. 🙂

Speaking of Mr. Hands, I had another encounter with him a few months after that. He called for a “quick” Psych referral per request of his consultant, at their ward. We don’t do “quick” Psychiatric evaluations in training of course, we treat every patient fully and interview fully and write notes fully. In other words, we do our work really seriously. So…I had the chance to “psychoeducate” him about “hurrying” the process.

. He recognized me when I made my way to the patient’s bed in the ward, and he talked to me personally about the referred patient. I was a little stern, I suppose, but I could not help but steal glances at his hands (and long, graceful fingers) every so often.

(I’m incorrigible that way. :-))

Anyway, up until I was done with training, we were ‘Hey’ friends (i.e. when we see each other in the halls, we’d go, “Hey.” or sometimes, “Hi!” and smile. He’s taller than everyone else, so I didn’t have enough time to look at his hands, after greeting, in the space of a casual passing at the halls.)

And that, ladies and gentlemen is the story of my crush on a surgeon’s hands…

And then there was the dude with the pen…

haha, but that’s another story altogether.

Farewell, Dr. Shepherd. 😦


Edit: This post was written in homage to a series which romanticizes the practice of medicine to a certain extent. You can tell that the effective storytelling skill of the creator and writers of this series because of how it has effected viewers on a major scale, myself included. However, I would like to admit that this entry was true at the time it was written, and does not necessarily reflect my current sentiments towards life today. (April 26, 2017.)

Love at first sight

Random quote from a book-browsing episode in Book Sale. March 2015.


I agree with Victor Hugo on this one…there is something about the whole love-at-first-sight thing that inspires poetry. Or quotes such as this one.

Perhaps it is much better to understand what VH means when you have had this “moment”. It burns deep into your heart, and it is unlikely to be forgotten, this “glance”.

The “slow burn” type of loving is good too. This type just “sparks” more creativity. 🙂

Do you believe in love at first sight?


New Arrivals

Cuddlers. April 2014

I sat in the back seat, but I could not help but snap this. Probably a couple who hadn’t seen each other in a while.

(People sometimes ask me if I was worried about getting in trouble for taking pictures of people. I do, I suppose, but I don’t take them out of malice, I take pictures to tell stories. Or they’d be gone forever.)

After the Storm

After the Storm. December 2014.
Surfers in Noir. December 2014.

After my cousin’s Mother-in-law’s (haha) birthday party last December, my cousins and I wandered over to the nearby surf spot… It was a unique little spot where the waves and correspondingly, the surfers converged, especially since the we’d had a storm.

I just took pictures here and there and have set them aside for a while. Since I woke up earlier than expected, I browsed through my pictures and looked at them through new eyes.  I was particularly inspired…and edited them in Noir filters, which I’ve never used before. It added a different dimension to the stories… 🙂

I use Snapseed the most these days…in fact, it is my favorite tool to use for editing. That’s a lot of magic you can do for a photo there. (I sometimes wonder how I could have lived without Snapseed if he hadn’t told me about it. haha.)

I would painstakingly edit my pictures before on Photoscape, but that was ages ago.

🙂 Snapseed is free to download.

Pro bono day at the Center

When I see patients, I usually like to take my time, especially for first consults. (I enjoy the interview process, and talking to people.)

However, I think there is a need to “tailor” my interviewing to the time constraint factor.

Earlier, I volunteered a local psychiatric facility in my locality. It’s a government facility, so I expected that there would be many patients to see. However, I got more than I had bargained for. 🙂 I’m not complaining about the sheer volume of patients, though. I was more concerned about not being able to give enough time for each one, as much as I’d like to.

This morning’s exercise proved to be a good eye-opener… For one thing, it taught me the basics of budgeting my time, and second, it gave me a first hand experience of the way people in more rural areas viewed Psychiatry. (They kept coming and coming into the room.)

The stigma of mental illness is still very real in the province where I’m from. Even the mention of the place I was volunteering at was enough to connote that image of “locks, cages and hopeless cases”. (It was not so, of course, the staff was competent and they knew what to do, it was just that the way people thought about things for a very long time.)

It was a mix of patients and relatives, with an equally varied number of problems… They ranged from * problems with sleep, up to problems with the government’s not having enough stock in the place (but I think that that man was just having a bad day.)

I was thankful for the time to do some volunteer work, and also to spend some time with the students who were getting their firsthand experience of the interview with a mentally-ill patient. I wish there were more chances to teach.


(I wish I had a car, though. That place was far.)

(I wish I knew how to drive too.)

My Lolly at 90

My grandmother recently celebrated her 90th birthday in a very colorful way…a Hawaiian-themed party by the beach. This one was of a candid moment while I was hosting the party, and she was the center of attention.

She’s a gem, and we love her everyday… 🙂