There's a joke about going to a psychiatrist: It's when you pay a stranger a lot of money to ask you the same questions that your spouse would ask for free.  Maybe your spouse can set a broken arm too, but you still might be better off seeing a medical professional.

Who needs a psychiatrist?

All jokes aside, life isn't always smooth sailing. Under certain conditions, it can simply bowl you over. Help can come in many different forms, but no matter if you are struggling with a chronic and severe mental disorder or you merely need help getting through a difficult period of your life, a psychiatrist can often help smooth the mental seas and make it easier for you to navigate to a more stable and healthier place.

That's because psychiatry grew out of medicine, and it is alone among the mental health disciplines -- with the exception of clinical psychiatric nursing -- in that it brings medication to the table. Psychiatrists are medical doctors. After four years of medical school they spend another four years in psychiatric residency; they take an arduous exam for board certification; and then for sub-specialty certification, they may do a further two- to three-year fellowship. In short, if you happen to need one, a typical psychiatrist is well prepared to provide help.

Carole Pifer, an Indianapolis-based psychiatric nurse, says that although her primary role is medication management, she brings lifestyle education to the table too. "Seeing an RN is also a good choice because the nursing perspective is holistic," she says. "A big focus of my practice is getting to know patients so well that my treatment plan is based on a whole person, not just someone with a condition needing this or that medication. When a patient calls me, I don't just hear a name; I hear a whole person."

But is your doctor the right one for you? In other words, are you and your pdoc (as psychiatrists are often called) a "good fit?"

What is a good fit?

A "good fit" refers to a feeling of "rightness," a stable, comforting, supportive relationship able to meet the needs that brought you there. The two words most often used to describe good fit are "empathy" and "compassion."

A Seattle-based psychiatrist, Dr. Merit Rome, says, "I would say that a good therapeutic relationship is essential to successful therapy. In ways unlike some other relationships, a psychotherapeutic relationship, by definition, must have clear rules, boundaries and expectations. These are what make it safe for a patient to share painful and often conflictual feelings with someone who is, at least initially, a stranger."

Finding a good fit is not only a key element of successful treatment. It is successful treatment -- at least of the first phase. Imagine sharing the most intimate details of your inner life and interpersonal relationships with someone you hardly know -- someone whom, to make matters worse, you're paying to listen to you -- and not feeling comfortable with them, or possibly not even liking them. How successful does that sound?

Now, that's a bad fit. You want to be taken seriously. You want to feel like you are in the right hands. This begins long before your first meeting. You should feel welcomed by the receptionist on your first call and be treated kindly, courteously and respectfully by everyone, even when just filling out paper work.

Next: The patient-therapist bond