Danger to self: on the front line with an ER Psychiatrist/Paul R. Linde

I heard Paul Linde interviewed on Michale Krasny's Forum earlier this year. He's Clinical Professor of Psychiatry in the School of Medicine, UCSF and a good writer in the genre of medical writing.
It begins with:
"I love my job when I'm not there. I'm a doctor in the psych emergency room at SFGH. One reason I work there is that when I'm not there, I'm not there. I have a decent shot at separating out my job's trauma and drama from the rest of my life. But in my workplace there's nowhere to hide." pxiii

He describes this work as "part-memoir, part primer and part commentary" pxx, though his interest is in documenting his experiences and those of his patients.

I don't expect to ever work in a psych ER, but Linde's work chronicles his education and learning experiences in psychiatry and psychotherapy.

The chapter entitled "The Psychodynamo: Learning to listen with a professional ear" has applications for counseling. His mentor helps him generate the following list of queries and questions for a therapy evaluation:

Describe someone important in your life
Describe one of the happiest, or best, moments of your life.
Describe one of the saddest, or worst, moments of your life.
Any recurrent dreams? What do you make of them?
How would you like to be? What would it feel like to be that way? What would be good about it? What would be bad about it?
p62-23

A the end of the chapter he lists in brief Ten Pearls of psychotherapy (in no particular order)

Be present
Create a safe environment
Help the patient discover his or her own tools of self-examination
Provide an emotional container
It's not logical. It's psychological.
Reveal things about your self only if doing so will help the patient. Don't do it to meet your own needs.
Follow the affect.
Take the middle path--don't be overly gratifying and solicitous, or overly detached and aloof.
It's okay to make errors of the head, but not errors of the heart.
Go where the patient leads you.
p.87

The epilogue also has an section to ponder.

"While I cannot fail to recognize and address painful emotions in my patients and my self, it is also my task to seek energetic joy and humor in the moment, to experience the buzz of empathy. This is the reward found in the work.
...Empathy causes a rush. It's addictive. Recent advances in the neurosciences confirm that the experience of deep empathy, with its associated glow of euphoria, shares some final common neurobiological pleasure pathways with narcotics, alcohol and cigarettes. In other words, empathy is addictive and pleasurable." p234

That sounds like it's possible to be an empathy junkie, though Linde goes on to talk about being present in the moment

The final two paragraphs:
"I discovered this: My heart, and not my words, provides the first and strongest line of defense when protecting myself in my work as a psychiatrist. In a seemingly paradoxical way, my best self-protection derives from actually opening my heart and laying its contents bare.
I experienced a measure of serenity and acceptance when I finally felt free enough to admit to myself that, while my head works pretty well, my real strength as a physician comes from the heart. " p237