'Shrink Rap' Gets Psychiatry Up Off The Couch For a profession devoted to dialogue and understanding, psychiatry is awfully misunderstood. You know the stereotype: the long couch, the dim lighting and the soothing voice asking, "And how did that make you feel?" In Shrink Rap, three psychiatrists explain what they really do all day.

'Shrink Rap' Gets Psychiatry Up Off The Couch

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This is TALK OF THE NATION. Im Neal Conan in Washington.

When we think about psychiatry, a lot of clich�s come to mind: a long couch, dim lights, a cozy office while a doctor, cigar in mind if no longer in hand, asks in a soothing voice: And how did that make you feel?

In a blog, Podcast, and now a new book called "Shrink Rap," three psychiatrists aim to demystify their profession, which in fact is often practiced in hospital emergency rooms and prisons, and where patients use the pharmacy more often than the couch.

Psychiatrists, what do you love about your job, and what don't you like? Our phone number is 800-989-8255. Email us, talk@npr.org. You can also join the conversation at our website. That's at npr.org. Click on TALK OF THE NATION.

Later in the program, branding every frame of a documentary to make a point - and a buck. Morgan Spurlock, on "The Greatest Movie Ever Sold."

But first, "Shrink Rap." Dr. Dinah Miller is a private-practice psychiatrist in Baltimore, and Dr. Steve Daviss is a hospital-based psychiatrist at Baltimore Washington Medical Center, along with forensic psychiatrist Annette Hanson. They wrote "Shrink Rap," and they join us today here in Studio 3A. Thanks very much for coming in.

Dr. STEVEN ROY DAVISS (Psychiatrist; Co-author, "Shrink Rap: Three Psychiatrists Explain Their Work"): Thanks for having us, Neal.

Dr. DINAH MILLER (Co-author, "Shrink Rap: Three Psychiatrists Explain Their Work"): It's great to be here.

CONAN: And people seek help for all kinds of reasons. In your first chapter, you talk about two people who seek psychiatric help under very different circumstances. Tell us about the patient you call Oscar.

Dr. DAVISS: So Oscar is a gentleman who - and these are fictional characters, of course. Oscar is a guy who is going through a divorce. He got separated. He's going through a very intense child-custody battle. He started drinking. He got very depressed. And he wound up having a DWI.

He said something about - to the police officer who arrested him - about wanting to kill himself, and was brought to the emergency room against his will.

CONAN: Against his will. So getting psychiatric help but against his will - at least, initially. There's another woman you write about, another fictional patient: Melissa(ph), who seeks help for a condition - depression.

Dr. MILLER: Right. So both Oscar and Melissa are depressed, and Melissa is a pediatrician. She comes down with very classic symptoms of major depression. She stops doing the things she usually does. Her sleep is disturbed. Her appetite is disturbed. Sometimes, while she's seeing patients, she leaves the room to cry. And everybody notices.

And the other thing about Melissa is that her fictional father - and we laugh, because this is funny to us, to be talking about fake people as though they're real people - but her father also had depression.

So she knows what's going on. I mean, she's a doctor, and she's been a child of somebody with depression. She knows what's going on, and it occurs to her that she needs to get help.

And the thing that the first chapter is meant to talk about is to explain how people get help. Melissa calls her primary care doctor, gets the name of a psychiatrist, and goes to see a psychiatrist who sees her for joint psychotherapy and medication management.

Oscar - oh, he walks through the whole prison system of getting care there, gets discharged with, you know, being told he needs to get care. And he goes to - he looks at his different options: one being a community mental health center; one being an out-of-network psychiatrist that will cost a lot of money, like Melissa's; another being a psychiatrist who participates in his insurance. And we use them exemplify the different aspects of what we do.

CONAN: What percentage, Steve, of your patients come to you involuntarily?

Dr. DAVISS: That would be a minority. I work in a hospital and see patients both on the inpatient setting, on our psychiatric unit, in the emergency room and on medical floors.

I would say the lion's share of patients who come in to be admitted to a psychiatric unit are coming in from the emergency room, so like Oscar did, but involuntarily.

The statistics at our hospital, I think, are around 10 to 15 percent. And that's probably typical, at least in Maryland. In other states, it may be different; I don't know.

CONAN: And Dinah Miller, you're in private practice. Presumably, all of your patients come to you voluntarily.

All of my patients come to me voluntarily. I will add, I'm not just in private practice. I think Steve initially - started that. I also consult at community mental health centers and - oh, since about 1998, I work part time at the Johns Hopkins Community Psychiatry Program.

CONAN: One of the things I learned from looking from your book was in fact we think of psychiatrists as being in control. Yes, true while you're dealing with the patient. Often, though, there are any number of other people, including other doctors, who are also talking to your patient and also prescribing for your patient.

Dr. MILLER: Absolutely.

Dr. DAVISS: And that can be one of the - so one of the challenges in today's, you know, modern medicine - not just in psychiatry but in medicine in general -is the coordination of care.

It's a time, now, where you may see a primary care doctor for one thing; a cardiologist for somebody else; and a psychiatrist; and maybe even a dermatologist who's prescribing a steroid for some eczema that you have. And all of these things can - the medications that are used can interact, sometimes in unsuspecting ways. So it really helps to have that communication going.

CONAN: Let me ask you a question we're asking our callers. What do you love about your job. Dinah Miller?

Dr. MILLER: Well, you know, I wake up, and I like going to work. I can't say I'm not happy at the end of the day, when it's over, that I don't look forward to weekends. But you know, I like what I do.

I like the people I work with. There's an intimacy to - I see patients for psychotherapy. So I see the same patients in a somewhat ongoing way, which is not to say that everybody I see comes in once a week. But many people start once a week.

You know, the people I see are very nice. They're extremely appreciative. People get better. It's rewarding. My days are pleasant. You know, some days are harried. Sometimes, people are in crisis. Sometimes, you know, you have moments where you say: Wait, why did I want to be doing this? Or why - you know, sometimes you feel responsible for other people's behavior, and that can be uncomfortable.

CONAN: Particularly if it's a little erratic.

Dr. MILLER: Well, you know, you're in the middle of having dinner, and you get a call that one of your patients has hit a few guards in an emergency room, and you feel a little like oh, gosh. And so - but yeah, it's interesting work.

You know, I like talking to people. I like hearing their stories. I like figuring out patterns and things. And it's - you know, could be worse.

CONAN: Could be worse.

Dr. DAVISS: Why do I like my job? Very similar things. As a physician, you kind of feel like you are Sherlock Holmes, trying to solve a mystery or a problem when somebody comes to you with a given set of symptoms.

In the work that I do in a hospital, I tend to see people for short periods of time. I don't see them for months or even longer than - like Dinah might. But it's very gratifying to come in, look at a situation, talk to the patient, maybe talk to a family member or their primary care doctor, get some more - put some of the pieces of the puzzle together, and try to figure out, you know, OK, what's wrong and what should we do. Here are some options that we can proceed with.

So I like helping people, and that's what I like the most about it. It's very gratifying.

CONAN: It's interesting - in your book, you describe the reasons -obviously, privacy, principally - to just write about fictional patients and indeed, about fictional doctors. But it's important, clinically, to have psychiatrists describe other patients to each other, doing their best to protect their anonymity in journals and other contexts.

But I wonder, at conferences or, you know, just as you meet people anecdotally, do you say, you know, boy, you're not going to believe the person who walked into my office the other day?

Dr. MILLER: You know, sometimes you do to other psychiatrists in a way that doesn't reveal who they are.

CONAN: Of course, yeah.

Dr. MILLER: You know, so you don't say: Hey, your next-door neighbor showed up in my office today. I mean, sometimes this is a little funny because, you know, I have patients who will talk about other psychiatrists that I know or their family members, or patients who will talk about each other. And you know, it can be a little funny.

Psychiatrists, as a whole, are a bit tormented about this question of how to write about patients. And I don't think we were spared that.

Dr. DAVISS: Dinah was probably more tormented than I was.

CONAN: Just as long as somebody felt bad. That's the important thing.

Dr. MILLER: Well, you know, I've had many conversations. One day, I picked up the New York Times and was reading an article by Ron Pais, who's a psychiatrist in New England, who's the editor of the Psychiatric Times.

And he was writing about a patient, and the New York Times does not let you confabulate. And...

CONAN: Oh, darn.

Dr. MILLER: Yes, so I - well, even if you say, they don't - they want the facts. So I thought: I think that person could be recognizable. I'm not sure. And I sent him an email. I don't know him, but I sent him an email saying - and we ended up in a long, back-and-forth discussion of this. And he ended up writing an article on confidentiality.

And I think we - the way we got over being tormented was to use fictional patients, to not try to use real people. And the other convenient thing about that was if they were fictional, we could walk them through the plot in a way that enabled us to describe our field. We didn't have to worry about: Did our patient really become manic then? And, you know...

CONAN: Our guests are Dr. Dinah Miller and Dr. Steve Daviss, the co-authors, along with another psychiatrist, of "Shrink Rap: Three Psychiatrists Explain Their Work" - 800-989-8255; email talk@npr.org. We'll start with Ann, who's on the line with us from New York.

ANN (Caller): Hi, thank you very much. I would like to ask Dr. Daviss a question: My sister was admitted to emergency when she cut her wrists, and the doctor on call pulled me aside and said, do you think she was trying to kill herself?

And I said - because my sister is very intelligent - I said, if my sister really wanted to kill herself, she would have done it. I think she's asking for help.

And so he said - and so he had her see the psychiatrist who was on call, or on duty. And she spoke with him for a while. And he sent her home, saying: Well, if you need me, I'm here.

What I would like to ask Dr. Daviss is, what protocol was going on there? Why did they allow that to happen? And what would you change, if you could?

CONAN: And obviously, he can't diagnose your sister's condition secondhand - on the radio - but go ahead.

Dr. DAVISS: Yeah, sure. And this is not an unusual situation - where somebody comes to an emergency room setting and has done something, possibly to harm themselves.

And oftentimes, they're coming in - more often - voluntary than involuntary. And they are asking for help. And so it sounds like that in this situation, I would presume that the psychiatrist spent some time talking to your sister, getting some more information, and trying to understand: Is this somebody who is at high risk of imminent danger?

And also from state to state, there are laws about whether you can admit somebody voluntarily or involuntary into the hospital. And if somebody doesn't meet criteria for involuntary hospitalization, sometimes the option is to discharge them - but trying to hook them in, into outpatient treatment is the -really, number one goal.

CONAN: And we hope your sister's doing well. Thank you very much for the phone call.

We're talking about psychiatry. We hope to hear from some psychiatrists as well as some patients; 800-989-8255. Email us, talk@npr.org. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

(Soundbite of music)

CONAN: This is TALK OF THE NATION. Im Neal Conan in Washington.

Today, everything you wanted to know about psychiatrists but were afraid to ask. The field is full of misperceptions and stereotypes. Three psychiatrists set out to change that. We're talking with two of them.

Drs. Dinah Miller and Steven Daviss co-wrote the book "Shrink Rap: Three Psychiatrists Explain Their Work." If you're still confused about the different types of mental health professionals, they've put together a breakdown of the many kinds of psychologists, psychiatrists, social workers and psychoanalysts, in an excerpt from the book. You can read that at our website. That's at npr.org. Click on TALK OF THE NATION.

And we'd like to hear from practitioners today. Psychs, what do you love about your job; what don't you like; 800-989-8255. Email talk@npr.org. Probably, they don't like being called psychs. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.

And let's see if we can get another caller on the line. This is Bill(ph), Bill with us from Ventura in California.

BILL (Caller): Yes, my question is: Given what I've read about the profession, and given that most psychiatrists at least - not psychologists - seem to be doing more and more prescribing and less and less therapy, do you feel that, maybe not for you folks but for your colleagues just entering the profession, that the training isn't accurate? Or it doesn't follow what they should know in terms of getting a lot of training in psychotherapy, but not doing too much of it on the job?

CONAN: And maybe some practice in calligraphy as well. But in any case, Dr. Daviss?

Dr. DAVISS: So - no, I haven't been in training for 15 or 20 years or so. So I don't know what they're doing...

Dr. MILLER: I'll take that question.

Dr. DAVISS: OK, sure.

Dr. MILLER: I think the simple answer is - I think I was thinking, no. I forgot what the question was but...

CONAN: Should the training emphasize more medical dispensation rather than therapy? Is the emphasis rather - now, these days - on something you don't really do as much as you used to?

Dr. MILLER: Well, you know, the thing about psychiatry, there's not a one-size-fits-all answer for anyone. And people have tended to think that psychiatry has become all about writing prescriptions.

And has it? It has for some people. It certainly hasn't for everyone. I sublet space in my office to two psychiatrists who just finished residency, and they both see patients for psychotherapy. And the New York Times, again, had this article a few weeks back about the psychiatrist who sees 40 patients a day, and I don't know how he does that.

But yeah, the emphasis on - is it more on medicines? It's really important for psychiatrists to know about therapy as well. It's not important that every psychiatrist do therapy because many don't like doing it.

In many regions of the country, there's just not enough psychiatrists to go around. And you know - but you do need to know what it is, how it works, and how it can be helpful. And I think there probably should be more emphasis.

Dr. DAVISS: And regarding Bill's question, I think that the trainees nowadays do get a lot of psychotherapy training. But once they get out, and they've got $250,000 in bills from medical school and so forth, some of them - a lot of them wind up going into types of practices that compensate higher, and those are types of practices that do not focus on psychotherapy, unfortunately.

Dr. MILLER: Or they have a mix. Some people see a few psychotherapy patients and do more medication management. I think the thing, one - you asked what do I like about the field. I like that there's so much diversity, you know - that you can come out and practice what you like doing.

CONAN: There's, I think, a subtext. And Bill, I don't mean to put words in your mouth. But I think some people are curious about this, the idea that just -that writing prescriptions is somehow just passing patients off with medicine, and not giving them the help they need.

Dr. MILLER: It depends how you do it. You know, some people do it very thoughtfully, and do listen. It's not necessarily - it depends how you mix it with psychotherapy. In clinics, there tend to be social workers who do the therapy, but they're using the same chart. They see the psychiatrist. They talk to the psychiatrist, and it's coordinated team care.

Dr. DAVISS: You have to know your patients well to do a good job at this. You can't not talk to them and just write prescriptions - which is, sometimes, what the portrayal is.

And you know, really good psychiatrists will learn about what their patients' problems are, to help understand when does a medication make sense, how do you assess for side effects, and what about talk therapy.

And if you're a psychiatrist that doesn't do a lot of talk therapy, you're going to be referring patients to people who can, other specialists.

Dr. MILLER: I think...

CONAN: I was just going to say - I thank Bill for the phone call, appreciate it. And here's an email we have, this from Mitch(ph) in Molino in Oregon - two questions, actually. One, should all therapists participate in their own therapy?

Dr. MILLER: Oh, we talk about that quite a bit in the book, don't we? We mention it in several places. I think we decided that if a therapist wants to or has a psychiatric disorder themselves, then they should. And if they don't have a psychiatric disorder, and they don't want to, they shouldn't.

CONAN: And this - do you agree?

Dr. DAVISS: Absolutely. I mean, psychiatry is about treating people with mental illness, and if you have a mental illness, you'd want to get treatment. I would imagine that the majority of psychiatrists don't have a mental illness, and if they do, they need to get help.

CONAN: The second question: Do you have trouble making or maintaining relationships because you're a therapist?


Dr. DAVISS: You mean, personal relationships with...

CONAN: Well, do you have - sometimes fall into the aspect of psychoanalyzing people or acting as a therapist in your personal life?

Dr. DAVISS: This is one of those common party questions that we get: Are you psychoanalyzing me? Or, what do you think about this? My usual answer to that is - when they ask me, are you trying to analyze me right now? I usually answer, kind of glibly, only if you're going to pay me.

CONAN: Here's another email question, this one from Paul(ph) in Liberty, Missouri. What can be done about a psychiatrist, or a series of psychiatrists-slash-psychologists misdiagnosing your problem? Is there malpractice in the same way as there is for doctors who deal with physical pain and injury? What are the damages for hits to my self-esteem due to years of misdiagnosis?

Dr. MILLER: There are - you know, psychiatrists carry malpractice policies. There are malpractice litigation cases. You can complain to your state licensing board. However, I will tell you that it's usually things like - you need damages. And "damages to my self-esteem" probably won't be something that financially gets equaled out.

Dr. DAVISS: One thing we've heard on our blog is that patients will say that -I've been seeing somebody for two years, and I don't think they're doing any good. And you know, a general comment is - and I think this is true, probably, in most areas of medicine - if you're going to see somebody, and you feel like they're not helping, tell them that it's not helping, and think about finding somebody else.

Dr. MILLER: Get a consult. You know, you can see somebody one time and ask for an opinion.

CONAN: Here's a call from Jason(ph), Jason with us from Humboldt in Iowa.

JASON (Caller): Hello?

CONAN: Jason, you're on the air, go ahead.

JASON: OK, thank you. Say, I was wondering your panel's opinion or thoughts on when you go to psychotherapy or see a psychologist or psychiatrist, after in treatment maybe for a year over your issue, whatever you went to see them for, the therapist may be reluctant to let the patient go, or maybe curtail some of the therapy treatments.

So let's say you're seeing somebody once a week, and you've been doing it for a year, and you may tell your therapist: Well, you know, I'm getting better. I think maybe, you know, once every two weeks, or once every three weeks, you know. I'm feeling better.

And sometimes, the therapist or the psychologist or psychiatrist's reluctance to kind of let the patient go, and there's kind of - maybe sometimes - a co-dependent relationship there, where it's - you know, you built up this rapport with your patient or whatever, and maybe the therapist - you know, not willing to let the patient go or...

CONAN: I think we get the question, Jason. I wonder, Dr. Dinah Miller.

Dr. MILLER: Well, I think that if the therapist thinks that the therapy needs to continue with the same frequency, they should be able to articulate why. It should be: You're still having these symptoms. Or, I'm worried about something, you know, something fairly discussible happening.

It's hard for me to imagine, you know, if somebody's getting better and they say look, I want to come less often, that that would be a problem.

CONAN: Jason, thanks very much for the call.

JASON: Thank you.

CONAN: Email from a psychiatrist, who says: As a psychiatrist with 20 years experience in multiple settings in three different states, what I love about my job is the opportunity to alleviate suffering and alienation at a human level.

Many of the patients I have seen have bad experiences with prior treatments. Even a 15-minute interaction has the potential for profound healing to take place. I need to know the medications, but more important is the ability to create a genuine and compassionate connection.

And Dr. Steve Daviss, you're sometimes in that kind of a situation. I should have said that was from Kurt(ph), not somebody who preferred to remain anonymous.

Dr. DAVISS: Yeah, I think Kurt said that - that was beautiful, the way he described that, and that's very much how I feel. I'm getting to know people on a daily basis. I may see them in the emergency room or in a hospital setting because they're there for pneumonia or chest pain or something like that, and for whatever reason, I'm asked to see them.

And very quickly, you do have to put somebody at ease, tell them what you're trying to accomplish, to find out what their problems are. And there's a lot of, I guess, personality and style that goes into that ability, to talk to somebody about very personal things. But the relief or suffering is definitely, I think, right up there.

CONAN: Very personal things within the context of a sometimes very brief interaction.

Dr. DAVISS: Absolutely.

CONAN: Let's see if we can go next to Rob, Rob with us from Phoenix.

ROB (Caller): Yes.

CONAN: Hi. You're on the air. Go ahead, please.

ROB: Yes. My question is, is that I actually started my medical career as a psych tech in a state hospital. And what I watched was, as patients were moved out of the state hospitals, they were to be followed in the community mental health centers. And they, unfortunately, never were funded or expanded to the extent that they were. And basically, what I've seen is many of the chronically mentally ill have wound up in our jails, in our prisons, who - in many communities, actually are the acute psychiatric training facilities. And I'll take my answer off the air.

CONAN: OK. Rob, I think, was talking about the...

Dr. MILLER: Actually, we can answer on the air. You'll love our book. A lot of it is forensic psychiatry. You're absolutely right that the prison system, the correctional system is the biggest provider of mental health services in this country. And we have a lot of forensics in the book. Ann Hanson is not with us today, but she is brilliant - and a walking encyclopedia of forensic knowledge.

Dr. DAVISS: And - but he's absolutely right. What Rob talked about is the way that state psychiatric hospitals have closed down...

CONAN: Beginning the late '60s and throughout the '70s ...

Dr. DAVISS: That's right. Yeah. There's used to be, I think, about 500,000 beds in - throughout the country and now, there's about 50,000 or so. So it's about 10 or 15 percent of what it used to be. And that's one of the things that we struggle with, is how many psychiatric beds do we need, and what about community programs? And the funding of mental health care is one of the things that has, unfortunately, continued to ratchet down because you can't do a blood test for mental illness. You can't do an X-ray or a CAT scan for mental illness. And so it's very easy for these kind of unseen - silent, maybe - problems to get swept under and not funded for things like, you know, breast cancer, other types of -you know, cardiac disease, which is very easy to kind of demonstrate.

CONAN: We're talking with Dr. Steve Daviss, who you just heard. Also with us, Dr. Dinah Miller - two of the authors of "Shrink Rap: Three Psychiatrists Explain Their Work."

You're listening to TALK OF THE NATION, which is coming to you from NPR News.

And let's go next to Robert, and Robert with us from Columbia, Missouri.

ROBERT (Caller): Hi. Good afternoon. It sounds like a great book. I'm looking forward to it. I'm a psychologist, and I love my work for the same reasons, I think, a lot of the people have - have described, that it's the helping tradition. It's helping people. But the other thing I wanted to bring up, and maybe get comments about, is this blurring that's occurred in our industry, where we have licensed professional counselors and sort of licensed level, master's therapists. We have psychologists. And then, perhaps, at the upper end of that pyramid, we have our psychiatrists.

And now, some psychologists are being given the ability and the training to dispense medications, certain kinds of medications. And so I think the public has more of a blurred vision that we, even in our trades, have. And I'd be interested in hearing your guests' comments on that particular topic.

CONAN: I think you say in the book two - in two states, psychologists are able to write prescriptions but...

Dr. DAVISS: Yeah. And I think right now, there are eight other states with the legislation where they're trying to get prescriptive authority. And this kind of turf battle - some people see it as - is something that's being going on for some time. I feel that it's important for somebody to have a strong medical background because one of the arguments that's used by non-physicians and -I'm not talking about nurse practitioners, who also have some significant medical training - is that, well, I'm only prescribing a medication that just affects the brain. And since that's what I do with my therapy, I should be able to do that.

The medications don't just go to the brain; they go to the whole body. They affect the liver, the kidney; there are drug interactions. And you really need to know - in medical school, we're taught a whole lot of things that later, we may not use, but we know that we used to know something. So that way, when we see it we go oh, this is something I used to know and this is a problem, and we need to get some help with it. But if you don't know what you don't know, you're going to get into problems.

Dr. MILLER: Yeah. We go through, in some depth, at the beginning of the book exactly what a psychiatrist is compared to what a psychologist is or what a social worker does or what a nurse practitioner does. The turf issue, it's a hard one.

You know, there are two states that have licensed psychologists prescribing, with some extra training. The Department of Defense did this for awhile, and they stopped their program because it just wasn't cost-effective. And then the two states that have OK'd it, they have done so because of concerns about there not being enough psychiatrists. And there hasn't been any evidence that letting psychologists prescribe lessens the problem of under - of people being underserved. And no one knows if it's safe. So I think we're waiting to see.

Dr. DAVISS: I think a much safer thing to do would be to have more training for primary care physicians to - they treat the lion share of depression now anyway.

CONAN: Robert, thanks very much for the call. I just wanted to end - when you see a situation in the news like the shootings in Tucson a couple or three months ago, and see - at least the person who's been charged in those - a situation where somebody seemed to have needed help and was not able to get it one way or another - did not ask for it, as far as we know - but slipped through the systems, what - we all did sort of amateur psychiatry; what did you guys think?

Dr. MILLER: We felt sad. I mean, this is a tragedy, you know, that somebody who needs help didn't get help. You know, I think we all Monday morning quarterback the system and say, you know, what could have been in place that would have helped? You know, psychiatry, everything about it is a bit of a tightrope walk. You know, you - on the one hand, there's how do you get help for somebody who's potentially dangerous? And on the other hand, there's how do you not violate the civil rights of people who might not be dangerous? And you know, how do you get it perfect?

Dr. DAVISS: And that's one of the reasons why we wrote this book - is because we wanted to explain to people how psychiatry works in different settings, how to go about getting help when things are going wrong, what to do about that when therapy goes wrong. So we talk about that in the book. In this situation, you know, it can be challenging, sometimes, to force somebody to get help if they need it but they don't want to. And if that's a problem, we talk about that quite a bit in our book.

CONAN: Doctors Steve Daviss and Dinah Miller, two of the authors of "Shrink Rap: Three Psychiatrists Explain Their Work." Their co-author is Annette Hanson, and we thank them for our time. They joined us here in Studio 3A.

Dr. MILLER: Thanks for having us.

Dr. DAVISS: Thank you very much, Neal.

CONAN: Coming up, a new documentary exposes the pervasive practice of product placement in Hollywood - "The Greatest Movie Ever Sold." Stay with us.

It's the TALK OF THE NATION from NPR News.

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