Psychiatry training through watching Seinfeld

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birchswing

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Link: http://www.cbsnews.com/news/the-psychology-of-seinfeld/

Since I know very little about how medical school students are ordinarily trained in psychiatry, it is beyond me to comment on whether training through watching episodes of Seinfeld is an improvement.

A few things do strike me, though.

The first is that there may be an assumption that the show Seinfeld was written with an intention to accurately reflect the nature of human beings (it was a short article, so I suppose I don't know what the professor believes on that point). Even if the show were written to accurately reflect the nature of human beings, the sitcom shows the lives of characters in a non-clinical environment. If you assume that these are real people living out real lives (as I suppose you have to do for the purposes of psychiatric training), then you have to recognize that you are viewing people surreptitiously, as if there were hidden cameras in patients’ environments that doctors used to diagnose behavior. People obviously present very differently in their private lives than they do when being interviewed by a psychiatrist. So is viewing people "in the wild" useful if it's not something a psychiatrist will normally ever do (again, this is already accepting that the people "in the wild" are fictional characters)?

I don't personally read for authorial intent—I enjoy the creation that comes with interpretation. But that's about entertainment—not training. I would say that, at the least, finding mental illness in a show that isn't specifically about mental illness perhaps allows more creativity than, say, watching Silver Linings Playbook (although I do like that movie). But if the professor has pre-determined what traits are in each episode, then I'm not sure if the creativity benefit applies.

The other thing that struck me is something I’ve found in real life with psychiatrists. There is a way in which outpatient psychiatrists I’ve seen seem to be somewhat divorced from frank mental illness. At outpatient practices I’ve been to, psychiatrists are scandalized and surprised at seeing symptoms of severe mental illness. There is a delicacy that would surprise me if not for waiting rooms of seemingly perfectly well-adjusted patients. Never seen a single jumpy individual, apart from myself. Anyhow, reading about this training reminded me of that long-term observation that psychiatrists I've seen are a bit squeamish about actual mental illness. Mental illness is already diluted in public media. Anxiety is conflated with stress. OCD is conflated with normal quirks. And it seems that eccentric fictional characters on a sitcom are being conflated with real-life personality disorders.

I have to say, it didn’t sit right with me. On the other hand, I don’t know what normal psychiatric training entails for medical school students, so perhaps this is a nice, lighthearted respite from ordinary training. I’m open to the idea that it could be useful.

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If you assume that these are real people living out real lives

Almost all the characters in Seinfeld are based on real life "characters." That said, I don't know how useful this sort of a training would be for medical students. I didn't even learn much from "movie nights" as a resident. It can be a lot of fun, sure. But the learning is questionable, especially for med students who I'd rather have learn to recognize (and not fear) mental illnesses, and do basic evaluations and treatment of simple presentations, than recognize subtle (and arbitrary) personality "disorders."

And hopefully everyone replying to this thread would post a quote from this fantastic show. Here's mine:
George Costanza said:
I have a bad feeling that whenever a lesbian looks at me they think "That's why I'm not a heterosexual."
 
I don't think it adds much to being able to recognize pathology to watch a show like Seinfeld. They are more mildly neurotic and quirky than mentally ill. We watched part of an episode of Sopranos once during training just to analyze the non-verbals during a therapy session. That was a little more useful although not nearly as funny.
I put in two quotes cause I love Costanza.
George Costanza said:
Jerry, just remember, it’s not a lie if you believe it.

George Costanza said:
Would it kill you not to be so funny all the time? That’s all I’m askin’. This woman thinks I’m very funny and now you’re gonna be funny, so what am I gonna be? I’m gonna be a short bald guy with glasses who suddenly doesn’t seem so funny.
 
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This is at my program, but as I went to a different med school I haven't actually seen this curriculum. But from what I know of it, it helps in 2 ways:

1) it's more fun than reading a textbook so the students enjoy it more, on average.

2) I believe they recognize that none of the characters have mental illness as all are actually fairly well functioning. But they certainly have traits that are more memorable than a textbook.

The guy from the article, Dr. Tobia, actually doesn't like as much to use movies or characters that are explicitly about mental illness. He prefers making analogies from others.
 
I saw a ppt that used Harry Potter characters to illustrate PDs.
As best I recall it was:
Schizotypal: Prof. Trelawney
Schizoid: Filch
Paranoid: Mad-eyeMoody
Narcissistic: Umbridge
Histrionic: Gilderoy Lockhart
Antisocial: Voldemort
Borderline: Bellatrix
Avoidant: Neville Longbottom
OCPD: Prof. McGonigal
Dependent: Dobby
 
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