Psychologists who don't address themselves as "doctor."

edieb said:

Recently I ordered some training DVDs which featured several famous clinical psychologists and neuropsychologists lecturing to a crowd of various therapists. On it, I noticed the psyhcologists never called themselves "doctor" but would rather use "Mr.", "Mrs." or their first name.

Does anybody know the reasoning for this?

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I know some psychologists who "always" use the title doctor when dealing with other professions such as psychiatrists, lawyers, nurses, etc.. but who refrain from using the title amongst other psychologists because the title is a given and using it sounds a bit pretentious. My current practicum supervisor always calls other psychologists by the doctor title but everyone in the outpatient office all call her by her first name because she is just sooooo down to earth. I guess some psychologists are so comfortable in their own skin that the title is of lesser or minimal importance.

As for myself, I want to let my insecurities hang out there! So I will be demanding that everyone, even my family members refer to me as "doctor" Well at least my two older siblings should call me "doctor" since by doing so, they will implicitly admit that their younger brother is in fact the superior sibling! Well that's something I've known since I was 3 years old but finally after all these years they will know it too ! They don't have to bow or kneel before me, but if they coose to do so, that would be an extra bonus!

I understand being comfortable with your first name and not insisting on being called "Dr." I don't get why in a formal setting you would use "Mr." or "Ms" instead of "Dr.", which is I think what the OP was saying happened? That does seem kind of strange to me.

I mean you can call me "Sun", you can call me "Dr. Lioness." But calling me "Ms. Lioness" just doesn't feel right unless I'm talking to someone in a non professional setting and they don't know what I do.

In a professional setting I would use it because that is what is appropriate, though in a less formal setting with peers I would rather them call me by my first name. It is a mix of respect/etiquette, though I can see how people may see it as pretentious in other settings.

My friends joke that they'll never call me Dr., but I don't much mind because they know me from a less formal setting. I would be peeved if I was in a professional setting and someone I did not know called me by my first name.

I admittedly get frustrated when psychologists are in a setting with other professionals and patients present and they go by Jane, Joe, etc., as it sets the wrong tone. Maybe I am reading too much into it, but the interactions are different in settings where psychologists do that, compared to settings where they use formal titles.

Psy01 said:

I recall one math class I had in college, and one of the first things the instructor told us was, "Please don't call me doctor. Call me Jeff." Instant "bonus points" for him in my mind.

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I don't understand this but I come across it at school in the US. It seems like one of those very American things that feels alien to me. I would never tell my students to address me by my first name. Mr. Nerd, Professor Nerd, Prof, Instructor, all fine. My first name, not at all.

I'm sorry if this is not in line with the original OP's message but it seems to me that the changing of names came when I got to grad school for my MA. In undergrad, unless a professor specifically stated that they did NOT want to be called Dr., it was just assumed that you should. At my first RA job at the Medical University I worked at, I started calling my supervisor Dr, and he asked I only do so when around patients. Same thing at the few places I've worked at where there's a home base/patient center divide. Around patients, the doctors (physicians and psychologists) refer to each other by Dr., but once we're in lab they call each other by first name. I don't think I ever called a grad school professor Dr. I'm guessing this is when the pupil to peer transformation thing kicks in?

I think I'd probably follow that rule as well. If I taught an undergrad course, I'd probably expect to be called Dr. But then I'd probably introduce myself to any grad students I supervise with my first name. I don't know why that feels comfortable, especially during your first year when it's only been a few months since graduation.

In response to the OP, I think the use of Mr. or Ms. is somewhat strange in the situation you describe, though first name could be fine. I assume that after I graduate, "Mr." will become obsolete and I'll use "Dr." for anything formal, but I'll continue to be on a first name basis with co-workers, colleagues, friends, etc.

Some theoretical orientations paint the therapist as expert and as the patient's superior. Other orientations believe that the client is the expert, and that the therapist and client are peers. (My differential use of "patient" and "client" are deliberate.)

I can't see myself asking a client to call me "Dr." and I don't ask clients to call me by my last name.

Socially, I was taught that the title of "Dr." belongs solely to MDs, and I would never introduce myself socially as a doctor. I'm married to a Ph.D., and it's HUGE no-no among his colleagues to use Dr. socially... except for the 48 hours following your defense, when everyone should call you Doctor.

OneAtATime said:

Some theoretical orientations paint the therapist as expert and as the patient's superior. Other orientations believe that the client is the expert, and that the therapist and client are peers. (My differential use of "patient" and "client" are deliberate.)

I can't see myself asking a client to call me "Dr." and I don't ask clients to call me by my last name.

Socially, I was taught that the title of "Dr." belongs solely to MDs, and I would never introduce myself socially as a doctor. I'm married to a Ph.D., and it's HUGE no-no among his colleagues to use Dr. socially... except for the 48 hours following your defense, when everyone should call you Doctor.

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I would *NEVER* use the title doctor socially, outside of a professional setting and I think that same principle should apply to M.D.'s as well. It's just crass. But why should the rules be different for them than for Ph.D.'s?? The Ph.D.'s are actually the original "Doctor" and the degree is higher than an M.D. degree but I digress.

In professional settings, with physicians, lawyer, nurses and others I would "ALWAYS" use the title since it is important for client's and the professionals to understand that they are dealing with a person trained at the highest level rather than being thought of as something generic sounding like "counselor" or even "case worker"

JockNerd said:

I don't understand this but I come across it at school in the US. It seems like one of those very American things that feels alien to me. I would never tell my students to address me by my first name. Mr. Nerd, Professor Nerd, Prof, Instructor, all fine. My first name, not at all.

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Purely going by hearsay, but I have heard on several occasions that American professors tend to be much less formal and authoritarian then European ones. Just a cultural difference, though probably an important one to be aware of.

Psy01 said:

I can't tell you their specific reasons. But, I will say that, regarding those people I've known that didn't insist on being called "Dr." (and instead went by their first name), my evaluation of them was higher simply bc of that. I don't begrudge anybody using an earned title, but it can be pretentious. Others I've talked to about this have agreed. So, maybe that's at least part of why they're doing that.

I recall one math class I had in college, and one of the first things the instructor told us was, "Please don't call me doctor. Call me Jeff." Instant "bonus points" for him in my mind.

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Thats interesting, bc I and many others (mostly professors in my program) that I have talked to about this find what you describe with students as unprofessional. You are the teacher, they are the student. Do you think it pretentious that Barak probably prefers to be adressed as "Mr. President".....that a you should adresss a military man by his rank, or call a judge "your honor"?

I think my expereince may be similar to what JN was talking about. Being raised in an educated, and very strict Catholic family, I was taught that a certain amount of respect for those in positions of instruction or authority was not only deserved, but required. Priests were "Father so and so", the nuns were "Sister, so and so" my teachers were "Sister", "Mame" or "Ms. Last name," and my family doctor was "Dr. X." Not everbody wants to be view as, or turned into Robin William's character from Dead Poets Society...

Regarding my own future use of the title doctor, I'd also never use the title doctor socially, but then I'd never use the title Mr. socially either. A more interesting question though is what I would do when say registering for a hotel or plane ticket online when they ask you to choose a prefix. Is it putting on airs there to choose Dr. instead of Mr., knowing that's how you will be addressed on check in?

OneAtATime said:

Socially, I was taught that the title of "Dr." belongs solely to MDs, and I would never introduce myself socially as a doctor. I'm married to a Ph.D., and it's HUGE no-no among his colleagues to use Dr. socially... except for the 48 hours following your defense, when everyone should call you Doctor.

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1. I also dont understand this logic. What do you think latin word doctoris means?

2. Do you think your attitude contributes to the perpetuation of the view (especially in medical settings and hospitals) that clinical psychologists are a "mid level providers", are not "real doctors" (and dont really know what people mean when they say that), should not be viewed as experts, and are generally lower on mental health rung than psychiatry?

I know it's wiki but it describes the uses of the title Dr. by country/region. Interesting how some places limit the use of the title to only those holding a doctorate in medical/clinical professions.

http://en.wikipedia.org/wiki/Doctor_(title)

My family in Mexico thought I was going to be an MD when I told them I got into grad school. It was slightly annoying having to say that a psychologist is a doctor. They keep forgetting so I just say I'm going to be a psychologist. Makes me wonder with given history why the title became associated with MD's more so than other professions.

I think it's a cultural thing a lot of the time. And by that I don't mean a difference in culture because of nationality or ethnicity, but the culture of the particular institution.

At my undergraduate insitution, PhDs were uniformly not addressed as "Doctor". If you addressed them as such, they would correct you almost without exception. They didn't go by their first names either, at least not with us undergraduates, but they preferred to be addressed as "Professor." I told that to one of my friends who attended a different school and she thought that was weird. She wanted to know how you could tell the professors with PhDs from the ones without. And well, I went to an Ivy League school. They all had PhDs. Physicians were addressed as "Doctor" there.

It wasn't until I did a post-bac and medical school elsewhere that I realized my friend was right. My undergraduate institution was kind of weird and in my post-bac and my medical school anyone with a PhD was always addressed as "Doctor." When I initially addressed them as 'Professor", they didn't protest, but I got some funny looks and I soon adjusted.

I don't think the use of "Doctor" between provider and patient/client is intended to say anything in support of power differentials or expertise. The fact of the matter is that there is a power differential just inherent in someone paying someone else for treatment. The patient/client is the expert in terms of their own life and experiences. The provider is the expert in terms of evaluation and appropriate treatment. Were this not the case, there wouldn't be a point in paying someone for psychotherapy. And I don't have a problem with someone's training and expertise being recognized in the use of the title "Doctor". I think it's entirely appropriate. Nevertheless if some providers prefer (or don't mind) patients/clients calling them by their first name, then I think that's their choice. In my case, since my last name is kind of a monster, many patients call me "Dr. First Name", which I think is a pretty acceptable compromise.

I also think that arguments over whether a PhD or an MD/DO is a more advanced or superior degree are superfluous and divisive. Both are doctoral degrees and both are doctoral level providers. Both are entitled to use (and insist upon the use if so desired) the title of "doctor." So are lawyers for that matter, but they never do, which I find interesting. A difference of culture again, I guess.

Jon Snow said:

I would not feel comfortable calling a judge "your honor," (for?) the president "Mr. President" (at least this particular politician) or a priest "father."

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Calling our parish's priest "Doug" just feels weird to me. Although my wife nearly did take his head off with a mean line drive during a soft ball game last year. After which she blurted "Oh ****, Doug, are you ok? He was a crappy short stop...

Well this was a somewhat surprising discussion for me.

To start with, "Mr." I don't understand - that's a new one to me.

However, I've actually found psychologists who go by "Dr." with colleagues as a rare exception rather than the rule. They generally will do so with undergraduates in lecture-style classes, or patients. Beyond that, everyone is first name only. Even as a 20 year old undergraduate, professors generally preferred to go by their first name once I got to know them well (i.e. the ones I was an RA for). As a graduate student, I've come across VERY few faculty who expect me to call them Dr. Approximately half of those were total d-bags, which I expect factored into that insistence. I don't know that I've come across a single one who expects to be called Dr. by their peers (except around patients of course).

Frankly, most psychologists I've worked with would look at me weird if I called them "Dr.". I tried that with my advisor when I first got here and he put a stop to that almost instantly. I have somewhat similar views to Jon in that I have a general distaste for titles. I far too frequently find they are used as a substitute for competence. In general, I've found that MDs are more insistent on the title of Dr. and I have always viewed it as a negative and been more fond of our system. The title promotes deference...I don't want deference, I explicitly want people to question me. Anything that promotes deference has always seemed anti-scientific to me (again...with titles seeming to be used as a substitute for competence).

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erg923 said:

Calling our parish's priest "Doug" just feels weird to me.

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Haha , I agree...you can't not say "father" when you address a priest! At least not to me. That just seems an automatic part of their name.

If/when I get a doctorate, I'm going to be one of those annoying people that makes everyone refer to me as doctor. Just kidding. I guess it depends. But being a doctorate-less person now, I always make a point to call someone with a doctorate "Doctor" and never assume it would be polite to do otherwise unless they tell me.

ClinPsycMasters said:

I eschew the title "doctor." It's pretentious. I think therapist and patient are at the same level and the patient can heal the therapist as much as the therapist can heal the patient. If the person prefers to call me by my last name or first name, I'll do the same for them. If the patient is disrespectful or prone to boundary violations, I let them know. But I don't want to buy myself respect for being a doctor.

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The therapist and patient are equals, but they bring different things to the process and are not on the same level in every respect. And while I learn things from my patients every day, I never expect to obtain healing from them. And while I know you didn't say this and I am by no means putting you in this category, in my experience (and I've known some doozies) the therapists who go into this field expecting to do their own therapeutic work or achieve their own healing/psychological health via being a therapist for others are some of the worst, most boundary impaired therapists out there. I learn things from my patients every day. They have a lot to teach and I am grateful for that. But when I want to work on my own mental health, I go fork over some money to the LCSW across town whom I don't otherwise know and who doesn't refer to me (or I go get a massage). There's a reason, and a good one, why in the therapeutic process one person is paying the other one.

Anyway, I hope I didn't go off on a tangent too much.

Anyway, I don't find the title doctor to be inherently pretentious though I do know some people (both physicians and psychologists) who are kind of pretentious themselves about being addressed as such. Personally I find the title to be a term of acknowledgment and respect for holding a certain position. But I certainly don't expect deference for it and I generally don't insist on it's use either.

I love the parish priest softball game story!

Lighten up Alice! Psychology is the people business. If you are going to build close relationships with colleagues and clients, use your first name.

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Sounds like an argument I'd want to avoid

I probably fall more on the formal side when it comes to calling people doctors. I agree with others that there's nothing inherently pretentious about the title.

To me, obtaining a doctorate requires an enormous amount of work, talent, and specialization within a set of historical/cultural institutions and the doctor title is representative of that. It doesn't mean that a doctor is a better person than another, but the title recognizes the dedication and expertise of that person. I'll be proud to be called a doctor after my degree is complete because I know what it takes to get.

It seems to me that in the US (and this is just my perception) is that we're eager to dismiss anything that appears like a class system. We fought a revolution over it, after all. Still, I'm fond of the titles for the reasons I state above. And until I can convince people to call me "master" (maybe magister? sensei?), I'll have to wait for my PhD to check the Dr box on my warranty cards, to which I really do look forward

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Well, "sensei" means teacher, instructor, professor, etc., so you could technically get away with it, though people would probably look at you strangely or think you were teaching karate. Interesting, I know a professor from Canada) who will half-joking call students with master degrees "Master So-and-So."

Relatedly, it was quite an adjustment to come to very informal lab where my PI goes by her nickname much of time (as well as her first name) from a Japanese linguistic/cultural mindset where EVERYONE, even friends, has titles. In Japanese, you would NEVER call your professor or any other teacher by anything but a formal title, even if they were no longer your teacher and you knew them well outside of class--heck, even my parents refer to my old Japaneses teacher as "sensei" or "mrs.," and they don't speak Japanese and are of the same age as her.

Perhaps because of the time I've spent speaking Japanese, I always err on the side of using titles unless told to do otherwise. It doesn't strike me as pretentious, just respectful.

I haven't yet decided to what extent I'll use the "doctor" title when/if I get my PhD.

FadedC said:

Purely going by hearsay, but I have heard on several occasions that American professors tend to be much less formal and authoritarian then European ones. Just a cultural difference, though probably an important one to be aware of.

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Another cultural difference: While you see this behavior as "authoritatian," I see it as appropriately respectful, and an acknowledgement of the real difference in knowledge levels of the instructor and the student. Also, for me, it gets back to this (to me) weird of "plus 1 point" for the instructor who is on the first-name basis. I don't understand, at all, why that behavior is worth "1 point."

erg923 said:

Not everbody wants to be view as, or turned into Robin William's character from Dead Poets Society...

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Nor is it always clinically useful. Many cultural backgrounds and many individuals expect their therapist to demonstrate expertise. Otherwise, why would you go to them?

sunlioness said:

The fact of the matter is that there is a power differential just inherent in someone paying someone else for treatment. The patient/client is the expert in terms of their own life and experiences. The provider is the expert in terms of evaluation and appropriate treatment. Were this not the case, there wouldn't be a point in paying someone for psychotherapy.

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I think this is dead on. There IS a power differential and pretending it isn't there isn't useful. And, pretending it isn't there doesn't resolve problems that arise from that; you can let your students or patients call you by your first name and still lord power over them, and you can have a more formal name system and share power; I see the two as pretty independent.

I am a huge supporter of the therapeutic relationship, which is why I think it is important to provide a structured forum with clear boundaries and expectations. I'm not sure if, "Just call me Joe*" helps this because it may be misinterpreted by the patient as a step towards a different relationship, which then can impact the boundaries of the therapeutic relationship. Anyone who has worked with patients with significant Axis-II presentations has experienced boundary challenges, and I think shifting to a first name basis with patients would add to the issue.

*For anyone who recognizes this reference, feel free to ask for my Man Card.

JockNerd said:

Another cultural difference: While you see this behavior as "authoritatian," I see it as appropriately respectful, and an acknowledgement of the real difference in knowledge levels of the instructor and the student. Also, for me, it gets back to this (to me) weird of "plus 1 point" for the instructor who is on the first-name basis. I don't understand, at all, why that behavior is worth "1 point."

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Well I agree that's not authoritarian behavior, just formal behavior. When I said that American professors tend to be less formal and authoritarian, I was talking about a wide variety of behaviors that go beyond whether someone expects to be called doctor.

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MrFritzPerls said:

Lighten up Alice! Psychology is the people business. If you are going to build close relationships with colleagues and clients, use your first name.

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Sure, and ill just sit around in a cardigan sweater and sip coffee with them at starbucks too!!

I want my patients to know that therapy, and the therapuetic process, is not just a casual "chat" between buddies. Its a professional helping relationship. A chat with their friend "Joe" over coffee is free! They are paying me a butt load of money for this!! The least I can do is act professional and treat the situation as an important priority/business. Why would they come to be if they didnt view me as an "expert" who does this for living...like I said, coffee with their buddy joe is free. They have chosen something different....

The fact that you think one can not form a strong relationship/bond with someone if they dont use their first name is strange to me. Again, I think this goes back to JN and I's point that this is an apparent need (desire?) to make authority figures into "he's just like one of us." I am not sure how this is helpful (especially in the therapuetic relationship, where an inherent power differntial is present) or why we feel the need to do this.

On a slightly different note, my uncle who's a retired cop told me to put Dr. As a title on my driver's license because if I get pulled over, there's a chace they'll let you off easier : )

erg923 said:

The least I can do is act professional and treat the situation as an important priority/business.

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QFT.

Again, I think this goes back to JN and I's point that this is an apparent need (desire?) to make authority figures into "he's just like one of us." I am not sure how this is helpful (especially in the therapuetic relationship, where an inherent power differntial is present) or why we feel the need to do this.

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I agree. But, I see U.S. grad students undermining this all the time with their obsessive need to be liked by their undergrad students, and do things like give out candy and let the students call them by their first name. That seems bizarre to me. Why would anyone care if their students like them?

Hmmm...have to disagree with you there. The need/desire to be liked by others is an inherent human need. I think it's natural to care about that. As well as the belief that when people like you, and think you are a genuine person, are more likely to engage and be inspired by the content of the class/therapy session.

erg923 said:

Hmmm...have to disagree with you there. The need/desire to be liked by others is an inherent human need. I think it's natural to care about that. As well as the belief that when people like you, and think you are a genuine person, are more likely to engage and be inspired by the content of the class/therapy session.

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I could have been more specific: I meant as a parallel to the students' desire to see the instructor as buddy-buddy, the instructor's desire to be perceived as buddy-buddy rather than owning the power differential.

JockNerd said:

I agree. But, I see U.S. grad students undermining this all the time with their obsessive need to be liked by their undergrad students, and do things like give out candy and let the students call them by their first name. That seems bizarre to me. Why would anyone care if their students like them?

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erg923 said:

Hmmm...have to disagree with you there. The need/desire to be liked by others is an inherent human need. I think it's natural to care about that. As well as the belief that when people like you, and think you are a genuine person, are more likely to engage and be inspired by the content of the class/therapy session.

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I understand why they do that, but I don't think pandering to the students is a good idea. I teach, they learn....that is why they are there. I know I wasn't their favorite person when I taught, but that is because I made them learn to pass the class....a rather novel concept these days.

In terms of professors wanting to be liked by their students, I'm not 100% sure how the tenure proccess works but I have a hunch that if you get consistently low scores on the evaluation forms that they hand out at the end of class then it doesn't help. In that respect, wanting to be liked would be a very logical and adaptive career move.

The cultural differences are interesting, though. I had two Japanese TA's who felt very differently about formality. One felt that she should be representing strict Japanese education culture and was very formal with her name and names of others. The other TA felt that he was teaching in America and should do things on a first-name basis. I actually agreed with both.

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My Japanese teacher definitely was on the formal side of things--she insisted we learn and use proper keigo, though not with her--but I think we were better off for it in terms of navigating the culture and the language. I even sort of wish she had made us use formal verbs (-masu verbs) with her, as I always have to "check" my speech when I'm in situation that requires me to use the more formal language (versus the more informal plain/dictionary form--iku, da, etc.)

Anyway, off-topic. Also, it's nice to meet another Japanese speaker on the boards.

This is a very interesting discussion. Context is so important here. My grad program is pretty informal, and all of the faculty go by first name. Imagine my surprise when on externship a supervisor pulled me aside and "corrected' me for referring to him by his first name. I was initially stunned and then embarrassed.

Personally, I like informality. But I learned the hard way that not everyone feels the same way that I do. When in doubt now, I use "Dr".

Every organization has a culture. When you are entering in, you need to observe the ways of the indigenous.

In our CMHS, only physicians use "Dr." and it is only used by or in the context of their patients. All other staff (and trainees) are all on a 1st name basis.

I'm personally put off by folks (including MDs) who use "doctor" in restaurants, etc. but I agree that if someone has earned the degree they are entitled (in the most literal sense of the word) to do so--but this would include dentists, podiatrists and attorneys too. In that context it is clearly a personal choice.

In a setting where all psychologists were expected to use the title, I would learn to get comfortable with it, I'm sure, because it would be the cultural norm of the organization. In the context of therapy, however, I think the level of address should be equitable, so either both therapist and client use a formal title or both use a first name and I would introduce myself with my first name and invite them to use it. If they prefer to use a title then I would refer to them more formally as well.

I totally get that different organizations will have their own cultures, but I've long been a bit of an outsider and have grown quite well adapted to existence there, even oblivious to the awkwardness such contentedness can engender. Call me an eccentric. At the same time, I've long felt awkward around people, especially when it comes to making first impressions. So I wonder whether I may as well 1) give people a concrete reason to feel put off as opposed to leaving them to grapple with a free-floating sense of frustration, dread or suspicion, and 2) conserve my own limited social graces for the longer haul rather than squander them on balking first impressions. If at first there's likely to be a mutually felt awkwardness whatever I'm called, may as well call me doctor.

Then again, I've gone 43 years without a fancy title like doctor, so perhaps I can make it the rest of the way without it. Conversely, I've long argued against calling my clients "patients," anyway.

I guess it's way too early for me to have to think about this...

The patient/client debate is another (and probably related) issue. In the CMHC world "client" is the predominant term. "Patient" tends to be used when referring to the physician/psychiatrist's "client" in the context of receiving/needing medications or acute/inpatient care.

The mental health recovery movement advocates for "consumer" as a term as well.

So I think to be culturally competent we need to always be alert to the context and traditions and the meanings of these in the organizational culture, including being able to use multiple terms for ourselves and others and across settings.

Yeah, I think that's another "cultural" thing. In my experience, physicians say "patient", psychotherapists say "client", and crisis workers say "consumer".

For me (a physician), I mostly say "patient", but sometimes say "client." I see them as pretty interchangeable. I have had physicians chastise me for saying client though. It undermines our prestige or something like that. For some reason, I dislike the word "consumer". It just seems to devalue the therapeutic relationship to me. Like psychotherapy is akin to going to the grocery store in search of the makin's for potato salad. Attorneys don't call their clients "consumers" and I don't think we should either. Plus I just don't like the sound of the word. It makes me visualize people running around consuming things. But that's just me.

This might be obvious and add nothing to the discussion, but I think it's a personal preference, and I respect however someone would want to be addressed (well, within reasonable limits! ). I'm most comfortable by my first name and plan using it in academic and clinical contexts for the most part.