I went to a mental health clinic and was assigned to a black doctor. I'm 24 and white, work as a secretary and never had much contact with blacks. I'm uncomfortable and wonder if he can uderstand white people. He seems nice, but I'm worried. A Reader. Dear Reader:
Your apprehension is not unusual for a patient who encounters a therapist from a different race or background. A black person will often react with the same initial discomfort. We wonder if we will be understood, and whether a therapist can comprehend problems from a different cultural perspective.
If your doctor has been working in an integrated clinic, he has probably treated many whites. His experience has equipped him to deal with racial and cultural differences.
There can be problems, however. A client may be prejudiced or frightened and quit therapy, or perhaps become so antagonistic that therapy cannot proceed. A black colleague, for instance, once had a white patient who regularly used racial slurs. He found it impossible to treat the patient and transferred him to a white psychiatrist.
Usually, the black doctor-white client combination will work if the client freely expresses his doubts and feelings. This is not always easy -- particularly if the patient has reservations about the doctor because of his race. Most therapists will not take your attitudes personally, and with time, the issue of race will fade into the background, enabling you to work on your personal problems as you would with any doctor. Dear Doctors:
I've read that the biggest health problems are no longer just diseases but due to life styles. I know a little about what they mean -- that smoking is bad for your health -- but not about all the other things. Do you agree with this "life style" view, and, is so, why can't you psychologists and psychiatrists help us change it? A Reader. Dear Reader:
Physicians recognize that despite medical advances and cures for many infectious diseases, people continue to damage their health as a result of their life styles.
You gave one of the most important examples: smoking. Smoking is associated with lung cancer, mouth cancer and diseases of the heart and blood vessels. Yet a great number of people continue to smoke. Even more shocking perhaps, is that many teen-agers begin the habit despite health warnings; it seems likely high incidences of lung cancer and other lung diseases, such as emphysema -- restriction of the air passages -- will continue. The best approach to this problem would be prevention, but how do you break a strong personal and social habit?
Another example of a health problem related to life style is alcoholism and heavy drinking. Excessive intake of alcohol can damage the liver, brain and other body organs, and make one more susceptible to illness. Many fatal automobile accidents and homicides are directly attributable to alcohol abuse, too. Yet alcohol consumption continues out of control, despite the many health warnings.
Perhaps one of the most widespread life style hazards is overeating, coupled with a lack of exercise. Obesity can be a killer, leading to heart attacks, high blood pressure, diabetes and other diseases. Even though diet books sell by the score, many individuals are not able to lose weight and continue to overindulge their appetites. Physicians are pessimistic about the positive results of most weight-loss programs -- it is very difficult to discontinue lifelong habits, even when there is an immediate danger.
Psychologists and psychiatrists have been perplexed and stymied in their attempts to find answers. It seems the psychological impact of one's environment -- friends, advertisements and social practices -- is greater than most countermeasures a psychiatrist could provide in his office or hospital.
One ray of hope is the public's increasing interest in health matters. It takes a strong sense of personal responsibility to change one's social orientation toward smoking, drinking and eating.