psychoanalytical type questions on the interview trail

[nancysinatra]

How likely are these? What kinds of questions might come up?

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[Encephalopathy]

Of my 8 interviews, I got zero psychoanalytic questions. None of the programs were psychoanalytically-oriented, though.

 

[blabbyblab]

Haha, "So...you feel deeply about your mother?"

 

[nancysinatra]

Haha, "So...you feel deeply about your mother?"

Seriously, I've heard this happens.

 

[blabbyblab]

Just don't lay on the couch, whatever you do!

 

[Chimed]

I never had any specific "psychoanalytic" questions. However, I did have a a couple of psychiatrists probe a little deeper then what I would have expected. For example, because I something on my application that could imply a religious background, I had one interviewer ask me if I had any religious beliefs that would influence my ability to be a psychotherapist. He then proceed to ask about my past experiences and how those might come into play in treating my patients. Although it felt a little bit like I was being analyzed and was verging on the border of being inappropriate, it turned out to be a very fascinating conversation. A couple of other interviewers seemed to be a bit psychoanalytic. But interestingly enough, those were some of my favorite interviews.

 

[Anasazi23]

An actual question I've had:

"Tell me a reason why your mother is disappointed in you."

 

[whopper]

I had a few psychoanalytic questions.

I also had a few interviewers seemingly try to tick me off during the interview (which I ranted about quite a bit after it happened, I don't want to spin that wheel again).

I thought both types of questions were wastes of time, & if anything may just upset the potential candidate against the program, which in turn just hurts that program because then they're going to be matched lower on the list.

Psychoanalysis, if its going to go anywhere will take a lot more than 1 session for the therapist to get a good feel for the person they are analyzing. Anyone trying to something like that isn't going to get very far.

If they're at least doing it in a comfortable manner where the candidate feels comfortable, then fine. It could be even enjoyable for the interviewer & the candidate.

However if its done in a manner where wierd and inappropriate questions are asked-like the question Anasazi mentioned-that's getting into what I'm criticizing, and just plain inappropriate & unprofessional.

A question I got.....
"You're an Asian American, so I know you're in medicine because your parents made you do this, you made your parents' mandate, tell me what you think about that"

As for the interviewers that intentionally tick candidates off.....
http://en.wikipedia.org/wiki/Trier_Social_Stress_Test
http://www.vault.com/nr/newsmain.jsp?nr_page=3&ch_id=619&article_id=27681683&cat_id=3232

It happens. Trust me, I know dozens of people that have had that happen to them.

Unless you're in a position where you really have no where else you can go, or that program is that program you're just so determined to get into, if someone pulls a stress interview on you--I'd just be calm & shrug it off. Heck play around with them. As long as you got > 8 interviews, you're most likely going to get into a program & one where you got some choice in the matter. That program is just shooting their own feet. They're only going to interview you if they're interested in you. Don't think this is as bad as the medschool situation where you're a 1 in 1000 chance of getting in. Its more like 1 in 10 if you get the interview--and on top of that the other 6 of those other 9 candidates are probably not on par with you.

 

[masterofmonkeys]

haha I probably have the best answer to the 'you're asian american' question ever.

My parents DIDN'T want me to go into psych. They wanted me to continue playing with monkeys. I worked a second job in college so I could play for med school apps.

To the psychoanalytic questions, I say bring em on!

I'm expecting some given the personal content and strong opinions in my personal statement

 

[erg923]

I had a few psychoanalytic questions.

I also had a few interviewers seemingly try to tick me off during the interview (which I ranted about quite a bit after it happened, I don't want to spin that wheel again).

I thought both types of questions were wastes of time, & if anything may just upset the potential candidate against the program, which in turn just hurts that program because then they're going to be matched lower on the list.

Psychoanalysis, if its going to go anywhere will take a lot more than 1 session for the therapist to get a good feel for the person they are analyzing. Anyone trying to something like that isn't going to get very far.

If they're at least doing it in a comfortable manner where the candidate feels comfortable, then fine. It could be even enjoyable for the interviewer & the candidate.

However if its done in a manner where wierd and inappropriate questions are asked-like the question Anasazi mentioned-that's getting into what I'm criticizing, and just plain inappropriate & unprofessional.

A question I got.....
"You're an Asian American, so I know you're in medicine because your parents made you do this, you made your parents' mandate, tell me what you think about that"

As for the interviewers that intentionally tick candidates off.....
http://en.wikipedia.org/wiki/Trier_Social_Stress_Test
http://www.vault.com/nr/newsmain.jsp?nr_page=3&ch_id=619&article_id=27681683&cat_id=3232

It happens. Trust me, I know dozens of people that have had that happen to them.

Unless you're in a position where you really have no where else you can go, or that program is that program you're just so determined to get into, if someone pulls a stress interview on them--I saw just be calm & shrug it off. Heck play around with them. As long as you got > 8 interviews, you're most likely going to get into a program & one where you got some choice in the matter. That program is just shooting their own feet. They're only going to interview you if they're interested in you. Don't think this is as bad as the medschool situation where you're a 1 in 1000 chance of getting in. Its more like 1 in 10 if you get the interview--and on top of that the other 6 of those other 9 candidates are probably not on par with you.

What? David Hasselhoff isn't Asian......

You cant help but reverse the analytic issues here. Why do they feel they need to make statements like this? What is it doing for them?

 

[whopper]

My theories....

1) Narcissism: While getting into residency is much easier than getting into medschool, most candidates do not know this & are still in fear factor/PTSD mode from the stress of getting into medschool. That was their last similar experience to gauge the situation. Several interviewers know this & take advantage of it because they their jollies trying to crawl under people's skin, especially when those people are in a position where they are trying to impress the interviewer.

2) The old pimp mentality that still pervades several facets of medicine. The old teacher that believes that humiliation & other forms of psychological abuse to resident or medstudent will make them a better doctor. IMHO, its really #1, but #2 is the rationalization these people play in their mind.

3) Test of character--I will admit that if you got an Axis II Cluster B candidate, you will most definitely see some sort of acting out if you intentionally try to tick that person off. However, you're also going to tick off a lot of good candidates that will be turned off to the program.

 

[Chimed]

3) Test of character--I will admit that if you got an Axis II Cluster B candidate, you will most definitely see some sort of acting out if you intentionally try to tick that person off. However, you're also going to tick off a lot of good candidates that will be turned off to the program.

There's someone in our program that I wished had been interviewed in a way that would have uncovered their Axis II traits. Unfortunately, we all get the pleasure of dealing with them on a daily basis....

 

[Chrismander]

Of my 8 interviews, I got zero psychoanalytic questions. None of the programs were psychoanalytically-oriented, though.

I doubt you're going to get any "psychoanalytic" questions, as the main psychoanalytic "question" is a long uncomfortable silence...

You may get questions asking for introspection, or more personal questions than you'd get if you were interviewing in another field--questions about your own struggles (if they're on your application, or even if not), questions about your family life growing up, major relationships that are important to you.
Unless the interviewer is a total jackass (or the program's some cut-throat hellhole) it's just a way to see how well you relate personally in an encounter, how able you are to be introspective without being defensive, and how well you establish rapport. Unfortunately, a lot of good psychiatry residency interviews have to skirt what's "illegal" in the question realm--it helps if you know a bit about the program going in. For instance, a lot of programs asked me whether I had a significant other, or children, etc. Technically violations, but these programs are all family friendly (something I looked for going in) and were usually using the next breath to try to sell me on their family leave policy, while at the same time finding out more about me & more importantly how I thought about myself. Now if someone asks you about your family plans in a hostile manner, that's a totally different matter, of course...

As others have mentioned, they need to screen out people with obvious pathology that would interfere with their ability to function clinically, or would make the program run less smoothly. Like any job interview, denying any weaknesses (or "issues" here) when they ask you something personal is as almost as bad as listing off 20 weak spots in an unflattering manner. They want to see that you're aware of your good and bad qualities, so they know you're not a frickin' narcissist.

 

[hippiedoc13]

I doubt you're going to get any "psychoanalytic" questions, as the main psychoanalytic "question" is a long uncomfortable silence...

You may get questions asking for introspection, or more personal questions than you'd get if you were interviewing in another field--questions about your own struggles (if they're on your application, or even if not), questions about your family life growing up, major relationships that are important to you.
Unless the interviewer is a total jackass (or the program's some cut-throat hellhole) it's just a way to see how well you relate personally in an encounter, how able you are to be introspective without being defensive, and how well you establish rapport. Unfortunately, a lot of good psychiatry residency interviews have to skirt what's "illegal" in the question realm--it helps if you know a bit about the program going in. For instance, a lot of programs asked me whether I had a significant other, or children, etc. Technically violations, but these programs are all family friendly (something I looked for going in) and were usually using the next breath to try to sell me on their family leave policy, while at the same time finding out more about me & more importantly how I thought about myself. Now if someone asks you about your family plans in a hostile manner, that's a totally different matter, of course...

As others have mentioned, they need to screen out people with obvious pathology that would interfere with their ability to function clinically, or would make the program run less smoothly. Like any job interview, denying any weaknesses (or "issues" here) when they ask you something personal is as almost as bad as listing off 20 weak spots in an unflattering manner. They want to see that you're aware of your good and bad qualities, so they know you're not a frickin' narcissist.

Definitely agree with this. I didn't get asked any truly "psychoanalytic" questions on the interview trail, but I felt that several of my psych interviews delved more deeply into my personal life and background than I was expecting. I definitely got asked, "Sooo...tell me about your relationship with your parents" and stuff like that. Initially it caught me off-guard and that made me a little uncomfortable, but most interviewers were very conversational and that put me at ease. Chrismander is right, because of the nature of psychiatry residency and practice, some of the more 'personal' aspects that get less attention in the selection process for other specialties really are very key in trying to select a psychiatry intern class that will work well together and with the residents and faculty already at the program.

 

[whopper]

There's someone in our program that I wished had been interviewed in a way that would have uncovered their Axis II traits. Unfortunately, we all get the pleasure of dealing with them on a daily basis....

We had one get in, but her file was loaded with red flags & warnings. I'm not sure why the program took her in given these warnings & there were other candidates (heard some rumors, that's it). This person just did not have Cluster B traits, she had full blown Borderline & Histrionic Disorder (she had almost all the criteria of all of them). She also had elements of narcicistic personality DO & antisocial (I'm not kidding or exagerating). I was not chief resident during that admission process, so I was not a part of that year's process. Had I been, I would've voiced strong opposition. In my opinion, the stress test could've actually done some good there, but it was unnecessary, my program failed to heed the warnings on her file.

She was kicked out of the program during her first year.

The biggest thing as chief that I was trying to weed out of potential candidates is people with a clique mentality. I do not like it when residents try to form inner circles at the cost of intentionally exluding others. It hurts a program's morale & it does adversely affect the residents' ability & desire to learn psychiatry.

However I never figured out a proper method to detect it accurately. Everyone who I interviewed was so eager to please me, and its something that letters of rec, personal statements or Dean's letters will not report.

 

[nancysinatra]

Ok, so the thing I'm wondering is, if they ask about my relationship with my mother, aren't they really just trying to find out what kind of family I come from? Like, is my family stable? Did we get along and go to a nice country club? Or is my mom a cheerful, can-do, pull-herself-up-by-the-bootstrap-type who happily cans tomatoes all summer? I think that's the kind of people that are wanted in medicine. I get the feeling that medical departments desperately want to reassemble themselves year after year. Nothing too radical, you know. I doubt they want someone whose surly mother sat and complained in front of the tv year after year, eating pot pies, yelling at the kids to do the housework and forget about homework.

I'm feeling really discouraged right now. I have three interviews lined up and haven't got a thing to say about my early life, should it come up. You guys are all talking about how you don't want borderline/histrionic/antisocial people in your programs. Ok, I'm none of those things. But say someone in my family growing up was. Then I couldn't paint the idyllic picture of the Norman Rockwell upbringing that I KNOW the medical world deeply wants us have as our background. If I get asked about my relationship with my mom, I might have to say, well, it was rough, and no, I haven't figured it out. I can't say that though, or I won't get into any program because that will show a less than adequate level of insight and self-understanding, and also, it will be more Edvard Munch than Norman Rockwell.

Ugh. So what do I do? Medical school administrators always tell us not to lie.

(Note: above caricature of a mother was not based on my own. However, my family IS messed up.)

 

[whopper]

Just be yourself. Don't worry about it.

I'm not saying my way would be the right way, but I would say something to the effect of....
"Is there a reason why you want to know about my mother?, I'm not your patient, I'm an applicant." I'd say it non-defensively. If they were to pursue that line I wouldn't advise getting defensive. Just be calm & answer what you feel comfortable with. Don't 2nd guess yourself---you'll be your own worst enemy.

As for the psychoanalysis questions--don't be quick to assume they're being the bad guy I complained about above. Some of them might really just want to get to know you better & are using a psychoanalytic type of interview as that vehicle.

Personally, if someone pulled something like that on me now, and was being wierd & intrusive, I'd spar with them a bit. I'd say something to the effect of, "since you find it appropriate to use psychoanalysis in your evaluation of me as a candidate, and since I also am interested in finding out more about your program why don't you tell me about your own mother? Hey--why not? Spade for spade. If they can dish it out, its only fair to expect them to take it. If they started getting wierd like asking me about possible sexual feelings for my mom, then I'd ask them back to give me the same.

That's another reason why someone might pull psychoanalytical type questions. They're just trying to freak you out. Considering how theoretical & broad psychoanalysis is, they could be asking you these types of questions for any number of reasons.

Despite my rants, out of all my interviews for residency, I recall only 3 out of dozens of interviewers really getting out of line. For fellowship--about the same--2 out of about 30. Don't worry about it too much. You might not receive any at all, and if you do, you won't get that many.

Most questions ask for the same thing. By the time you've done your 3rd interview, you pretty much have all the formula down & know how to handle it. Rehearse a few times with someone. Preferbaly a resident who's been through it. If you do get a pressure interview, don't let them get under your skin. As long as you got plenty of interviews, you got choices. They want to give you a hard time? Ok well you don't have to go there & there's greener pastures for you to check out.

 

[hippiedoc13]

I'm feeling really discouraged right now. I have three interviews lined up and haven't got a thing to say about my early life, should it come up. You guys are all talking about how you don't want borderline/histrionic/antisocial people in your programs. Ok, I'm none of those things. But say someone in my family growing up was. Then I couldn't paint the idyllic picture of the Norman Rockwell upbringing that I KNOW the medical world deeply wants us have as our background. If I get asked about my relationship with my mom, I might have to say, well, it was rough, and no, I haven't figured it out. I can't say that though, or I won't get into any program because that will show a less than adequate level of insight and self-understanding, and also, it will be more Edvard Munch than Norman Rockwell.

Ugh. So what do I do? Medical school administrators always tell us not to lie.

(Note: above caricature of a mother was not based on my own. However, my family IS messed up.)

May I respectfully say that I think you are a little off-base here. No psychiatrist in their right mind expects all future psychiatrists (or future physicians of any type, for that matter) to come from an 'idyllic Norman Rockwell type family.' Because those families in large part do not exist. In fact, trying to portray your family as Rockwellian when it wasn't would display quite a profound lack of insight and self-awareness. If you get asked about your family just find a professional and diplomatic way to be honest. That doesn't mean spill all your deepest darkest secrets like you would to your best friend or your therapist. The person interviewing you may be a psychiatrist, but the interview should be collegial, not doctor-patient. Being able to say that your relationship with your parents is not perfect, and you haven't entirely figured it out yet but are working on it, is just about where I would expect most high-functioning people in their mid-twenties to be at.

And remember...you may not even get asked about this at all.

 

[masterofmonkeys]

There's a difference between having insight and having everything figured out.

Likewise, when it comes to motivation for the profession based on personal history, there's a difference between a mature response and an immature response.

Granted, I'm an MS4 just like you and on the interview trail myself, but my psych letter writers ALL did the psychoanalytic thing on me. I can't vouch for the motivations of anyone who does it in an interview, but I don't think it's necessarily a bad thing, nor would I be averse to doing it myself (about 80% leaning toward academia at this point). I believe it strengthened my letters (they all told me so). And it gave them a better insight into what I was all about.

I know people leaning psych who have no insight. I also know several who are going into it for immature reasons. Heck, I have spent a few sleepless nights wondering if I was. I think there's a certain amount of truth to that old saw that people going into psych just want to figure themselves out. I also think that there is a certain amount of appeal in the power you can have over someone else in the role of physician in general and psychiatrist specifically. Munchausens by healthcare provider, so to speak.

I forgot where I was going with this ramble. Oh yeah. There I went. If it were me asking the question about your mother, I wouldn't be wanting to know whether it was good or bad, so much as if there was any resentment or anything else that might be driving your choice in psychiatry. I'm not being very eloquent here, because I suck.

But here's an example:
Interviewer: tell me about your relationship with your mother
Response 1: We had some rough patches growing up. Part of it was culture clash. Part of it was that I just plain had different interests and proclivities than my parents did. They love me and did what they think was best. We've all matured. They support me 100% in what I do and we have a very loving, very solid relationship now.
Response 2: I hate my mother and my adolescence sucked because of her! Look at what she made me do to myself! (pointing to cutting scars on exposed forearm). I am going into psychiatry so that other children with horrible mothers won't have to suffer like I did!!!!

Here's another
Interviewer: "In your personal statement you mention personal crisis X which was a turning point in your life. Care to elaborate on how that motivated you to choose psychiatry?"
Response 1: "Most people who go through that turn into drug-addled, depressed losers with nothing the least bit positive about their characters or their souls! The ones that don't kill themselves anyway. I on the other hand am a badass! I proved I am better than them, and I can make other people better too! I am a god and people should worship me and bask in my glory! then they can be demigods or something. Or at least not suck as much as they do right now. It's like osmosis or something. By the way you probably don't want to wash that hand since you were bestowed the honor of touching my physical form.

Response 2: Yeah, you know I did pretty well through it. I avoided most of the pitfalls that others in my situation fell into. But that doesn't mean it was a walk in the park. It really opened up my eyes to how trying times can affect a person psychologically. Just because I never had a drug abuse problem or depression from it doesn't mean I can't see how they went down that road. That's why I want to learn how to help people make the most of their lives, no matter the circumstances.

Just a couple of examples *shrug*. Obviously overblown and hyperbolous. But that's how I'd roll if I were interviewing someone.

 

[nancysinatra]

Yipee! I love it when I'm off base when I'm worried about something. Last week my school had a meeting where a medicine attending told us how he got "concerned" when he saw an applicant who seemed to come from off the beaten trail in terms of the way he'd gotten through undergrad, which is how I got worried about my non-Norman-Rockwell-origins. OK, I am reassured now.

The things is, I am a high (or so I hope) functioning person in my mid THIRTIES, but the reason my relationship with my parents isn't entirely figured out even for my age is because a) I've been in medical school these past four years and b) they are very stubborn.

hippiedoc13, the whole "idyllic Norman Rockwell type family" thing is an interesting thing epistemologically. If you don't come from something even remotely resembling a Normal Rockwell type family, but you see it portrayed in the media, how do know if what you're seeing is real or just propaganda? People who live in reasonably happy families might realize that it's an idealized version of happiness, but people from unhappy families can't really tell at all, can they? When some medicine attending stands up in front of the class and talks about red flags in a student's past, someone like me gets nervous because I wonder if he really DOES want that "perfect" person from the Normal Rockwell painting. All these years later I still wonder if that kind of family was real! Ok, I'm exaggerating a LITTLE here, but do know you what I mean? (Or maybe you don't! Maybe ONLY people from unhappy homes can understand THIS quandry! hee hee! ;-) )

Thanks!

 

[nancysinatra]

May I respectfully say that I think you are a little off-base here.

Oh, and I just want to add--I was being facetious in that post about the medicine world demanding perfect little preformed people from their dollhouse worlds. I did say I was feeling demoralized and that's typically how I talk when I'm feeling demoralized. ;-)

 

[OldPsychDoc]

I referred in my personal statement to unnamed "loved ones" who had struggled with and overcome alcoholism and depression.
I had an interviewer very pointedly ask me if my reasons for entering psychiatry were that I was "on a rescue mission".
In retrospect, I think it was a legitimate concern, and I think she was just looking for some indication that I had some measure of insight about it, which I presume I provided.
We all have s--t in our lives. Hopefully the relatively healthy among us are aware of what that stuff is and have majored in the more mature defenses.

 

[nancysinatra]

We all have s--t in our lives. Hopefully the relatively healthy among us are aware of what that stuff is and have majored in the more mature defenses.

Yeah, and one of those defenses is humor. Now that I have plastered SDN with my jokes in the form of family melodrama I am feeling much healthier than I was 45 minutes ago. Too bad it would not look good for me to show up on interview day carrying a blow up doll of Munch's Scream, and a flask of Absinth ala Strindberg. That would say it all, but seriously, I will just go with the interview day folder they give us. Do we get keychains too?

 

[Chrismander]

There's a difference between having insight and having everything figured out.


But here's an example:
Interviewer: tell me about your relationship with your mother
Response 1: We had some rough patches growing up. Part of it was culture clash. Part of it was that I just plain had different interests and proclivities than my parents did. They love me and did what they think was best. We've all matured. They support me 100% in what I do and we have a very loving, very solid relationship now.

Dude, you just nailed it. Perfect answer.

Never bad mouth anyone else during an interview, period--parents, past attendings, your med school, whoever (wow we could probably do a whole bit on my identification of parents with attendings).
If you absolutely have to say something negative, at least mention your own failings in the same breath, then mention something positive about the person at the same time. Sort of like the "sandwich technique". Maybe more of an open-faced sandwich here.

And always redirect the topic to the positive--how much better things are, or if they're not then at least what you learned and how you've carried the lesson with you.

 

[nancysinatra]

I agree with what you're saying too about never putting down one's family or school. You're saying some of the same things I was thinking, but in a more gracious, uplifting way.

I know I write a lot of sludge on this board, but I'd never ever say anything less than kind and appreciative during an interview. Not that anyone was suggesting I wouldn't--I just wanted to clarify. In fact, I'll say better things having had the chance to vent my irrational thoughts here first!

Thanks for reading this--not sure it was necessary but I've been ranting here all evening so I just wanted to top if off with this!

Back to my research project...

 

[Spiderwoman]

The way I see it, if the interviewer is a good psychiatrist, almost all of us shouldn't have anything to worry about! For example, number of "I" used in personal statement should not truly reflect selfishness. Shelfish person has a way of centering him/herself in the content of his/her talks. This is not a professional comment, just talking from life experience.

Once I was "The Perfect Picture" for residency applicant. Now the only realy good thing on my CV is my scores. Life happened. As it happenes sooner or later for everybody. I made many good decisions as well as many bad ones. "Red flags" in my CV, as I like to see it, helped me mature more. I just hope those reviewing my application, keep open mind about what is considered Red Flags and think twice before rejecting it. I care about people truly. Knowledge and care would make a good psychiatrist, given a chance.

I would be honest in the interview. If he/she is an expert in his field then he would know.

 

[hippiedoc13]

hippiedoc13, the whole "idyllic Norman Rockwell type family" thing is an interesting thing epistemologically. If you don't come from something even remotely resembling a Normal Rockwell type family, but you see it portrayed in the media, how do know if what you're seeing is real or just propaganda? People who live in reasonably happy families might realize that it's an idealized version of happiness, but people from unhappy families can't really tell at all, can they? When some medicine attending stands up in front of the class and talks about red flags in a student's past, someone like me gets nervous because I wonder if he really DOES want that "perfect" person from the Normal Rockwell painting. All these years later I still wonder if that kind of family was real! Ok, I'm exaggerating a LITTLE here, but do know you what I mean? (Or maybe you don't! Maybe ONLY people from unhappy homes can understand THIS quandry! hee hee! ;-) )

Thanks!

First off, glad we were able to reassure you.

I think it's unfortunate but true that there are still some people, like maybe that attending, who despite all the **** we see on a daily basis, still believe on some level that doctors should come from backgrounds that don't include some of the same **** many of our patients are going through. Maybe it's just me, but I'd really prefer for my doctors--and my colleagues--to be the type of people who have experienced some of the crap life has to offer, and have successfully dealt with it. I don't think I'm alone here.

And finally...let's just say that my family-of-origin has provided me with plenty of, ahem, fodder for introspection and development of (hopefully) mature coping mechanisms. And the reason I asserted that Rockwellian families don't really exist is that I have seriously never met a single person who came from a family like that, once I started really talking to them. Though I suppose that doesn't technically prove they don't exist.

 

[whopper]

And the reason I asserted that Rockwellian families don't really exist is that I have seriously never met a single person who came from a family like that, once I started really talking to them.

My wife is from what I'd think fit a Rockwellian family--& as a result she did not develop proper coping mechanisms to fight back people who bullied her in high school. When she'd tell her parents what was going on, they gave her "perfect world" responses such as, "a young girl could never do that, if you're nicer to her, she'll be nicer to you."

Well as you probably figured, that response didn't work.

So, I believe these type of families do exist, which too can cause psychological issues.