The relationships between psychiatrists and the people who seek our help are necessarily one-sided. While we know many of the intimate details of our patients' lives, they typically know about us only what we choose to tell them - usually very little.

In the absence of personal information, people make assumptions about what their doctors' lives are like. Seeking reassurance that the person treating them has some special expertise in the universal struggle to live a controlled and happy life, it is common for patients to assume that their psychiatrist is not plagued by the same difficulties that they are.

These assumptions are frequently inaccurate. For example, I often find myself talking to people troubled by insomnia who are sleeping better than I am. Not wanting to undermine their confidence, I seldom confess this.

Likewise, psychiatrists are not immune to the mood variations that are part of the human condition. Underneath the air of professional detachment necessary to do our jobs lie our own anxieties and discouragement. (The fact is that in many cases, the effort to work these out played a role in drawing us to this vocation in the first place.)

So when our patients touch on situations that we ourselves have faced - divorce, rejection, loss of a loved one - it is not unusual for us to experience our own emotional reactions. Because I am a bereaved parent and have written about it, it is not unusual for people whose children have died to seek me out. It is hard sometimes to listen to their stories dry-eyed, though how can I help them if we are both in tears?

Sometimes something happens that fully exposes my own shortcomings when it comes to the effort to live a perfect life.

Recently, I was doing what is called a "mental status examination" of a patient who was referred to me to evaluate his fragile grip on reality. This exercise involves asking questions to determine such things as a patient's orientation ("What day of the week is it?"), his ability to reason abstractly ("Can you interpret the proverb, 'Even monkeys fall out of trees?' ") and his fund of general information ("Who is the vice president?"). A typical way to assess short-term memory is to tell the person three random and unrelated things ("Table, green, 501 Wolfe St.") and ask them to recall these in five minutes.

Having completed the mental-status exam on this patient, I discussed with him my diagnosis and recommendations for medication, including possible side effects, and the need for a follow-up appointment.

As I concluded the session using my customary subtle signal of standing up and opening the office door, the patient remained seated, smiled and said, "Aren't you going to ask me those three things you wanted me to remember?"

Searching for some plausible explanation for my obvious memory lapse, the best I could come up with was, "Even monkeys fall out of trees."

Gordon Livingston, a psychiatrist who lives in Columbia, is the author of books including "Only Spring: On Mourning the Death of My Son." His e-mail is gslcvk@aol.com.