How do you feel psychiatry influences your personal life/relationships?

[Horners]

As psychiatrists you spend a lot of time reading and treating the human condition and not just the mechanical issues, but the deep, emotional and pressing issues that make people who they are.

Do you ever find yourself implementing what you know about people into your own personal life and relationships?

For example, let’s say you meet someone who has an undiagnosed BPD, do you find yourself having a bit more sympathy/tolerance than the average person when dealing with them?

For the child psych folks, do you ever find yourself treating your children in a more nuanced way than other parents?

How do you feel like psychiatry has changed you as a person?



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[thoffen]

Yes it has although I don't really think clinically about the people I interact with outside of patients. Other people might change their interaction with me, though, on the basis of thinking I'm analyzing them. That gets awkward. Or an insight that really has nothing to do with clinical training sets people off. Really, people imagine what's going on in another person's head a lot, and they gossip about it too! Being a psychiatrist doesn't change that. What I've found more of though is a divergence of interests from people outside the field.

 

[Onions]

I sometimes feel like everyone is a patient. Or possibly nobody is a patient.

I've definitely gotten the "are you analyzing me?" To which I typically respond "I'm trying to, but I really don't know what I'm doing."

 

[redbandit]

I think it's made me a better person. I am better able to tolerate agitation, and stressful situations in general, outside of psych. I have noticed that the amount of mental energy I put into treating patients, drains a little bit of my tolerance for dealing with my own family, and I've caught myself getting snappy on occasion. But that is where our own therapy comes in. I don't think i really "analyze" anyone outside of work; I agree with what the person above me has stated. I will say, I was out at a bar one time, and this dude was showing signs of textbook mania, but my non-physician friends were also able to pick up on that hah.

 

[Shufflin]

My understanding of the human condition has gained much more depth. No longer are people just passer-byes, nameless faces among the crowd. Now I can discern, see more clearly through the fog, what people may be going through. I pick up nuances that reveal little clues to bigger issues even in strangers I see. It's very interesting. How people look at each other, speak, body language, things like that. I feel closer to my fellow man in a way. On a base level, I'm less self-centered and more empathetic - I can see things from the other person's perspective more readily. It's like heightened humanism.

Additionally, psychiatry abolishes the instinct to stereotype. Do you know how many times the part of my brain that stereotypes was proven wrong? Almost daily to the point that to expect the unexpected is expected.

 

[SourceOfDenial]

Additionally, psychiatry abolishes the instinct to stereotype. Do you know how many times the part of my brain that stereotypes was proven wrong? Almost daily to the point that to expect the unexpected is expected.

Interesting, I often feel like psychiatry trains you to pathologize and stereotype, and you have to actively work to push against it. It's one of the things I dislike about the field the most.

 

[WingedOx]

I've definitely gotten the "are you analyzing me?" To which I typically respond "I'm trying to, but I really don't know what I'm doing."

"Yeah, of course I'm analyzing you. If your attempts to compensate for the inadequacy you feel for having a small penis were any more obvious, it would be tattooed on your forehead."

 

[DD214_DOC]

It took a few years to learn how to, "turn off", the shrink stuff. I used quotes for a reason, as you can never actually turn off an entirely new way of thinking -- once you have crossed the line, you can never go back. "Turn off", actually just means I learned to keep my mouth shut and my thoughts to myself.

It did help tremendously, though, when I had to re-enter the dating pool. I'm so very thankful for the unfair advantage I had to identify red flags and run far, far away.

For the CAPS question, the answer would be, "yes and no". "Yes", in that I have a better understanding of what to expect, how to parent, and how to manage issues as they arise. "No", in that ultimately I'm still only human and a parent, and folley to all the same things as any other parent -- frustration, helplessness, making mistakes, etc. It's also considerably more difficult to recognize things and respond appropriately when you no longer have the outside objective perspective. It's very easy to educate a parent on how to manage the tantrum of a two year old during a sesison in my office. It's very difficult to actually do it when it's your two year old screaming and flailing around on the floor between the aisles of Target.

 

[WingedOx]

For example, let’s say you meet someone who has an undiagnosed BPD, do you find yourself having a bit more sympathy/tolerance than the average person when dealing with them?

On a more serious note though, I think in a lot of cases it can turn out to be the opposite.

The general public tends to view mental illnesses as entities which are beyond the control of the patient, but with a small number of exceptions this is rarely true and recovery requires that treatment not be seen as a passive process by the patient. Part of the role of the clinician is to educate the patient so that they can take appropriate behavioral steps toward their own recovery, (and learning to empathize with the fact that the patients do indeed need this education and often times don't know better at the onset of treatment), but when patients fail to take these steps, refuse to seek treatment, or relapse into a "**** it" mentality there's a lot of frustration on the part of the provider, and that seeps into interactions with those you see outside of your clinical responsibility too. Patients ultimately are responsible for maintaining their own mental health and I recognize that I can be overly harsh on those who fail to do so.

 

[Amygdarya]

"Yeah, of course I'm analyzing you. If your attempts to compensate for the inadequacy you feel for having a small penis were any more obvious, it would be tattooed on your forehead."

"That'll be $300"

 

[tr]

I'm not child-trained but actually learning effective CBT for adults has been very helpful in guiding my interactions with my kids.
Interestingly I own a number of 'how-to' books for parents and they are all mostly repurposed Five-Secrets type stuff.

 

[whopper]

I come home and because I've spent the entire day talking to patients one-on-one and being their pillar of strength, I just want to veg out and not talk to anyone.

Particularly annoying when my wife invited some guests for dinner and I don't want to be social cause I'm "social" 45 hours a week, keeping a calm face even when patients piss me off.

This issue wasn't anywhere near as bad until I did private practice. Cause in hospital care I often times had a few hours to myself while writing up reports or conferring with colleagues in an honest manner, not in a manner where I had to wear the hat of "guy who is not pissed off at you for malingering, grabbing that nurse's butt, and then demanding scrambled eggs with bacon."

 

[DD214_DOC]

I come home and because I've spent the entire day talking to patients one-on-one and being their pillar of strength, I just want to veg out and not talk to anyone.

Particularly annoying when my wife invited some guests for dinner and I don't want to be social cause I'm "social" 45 hours a week, keeping a calm face even when patients piss me off.

This issue wasn't anywhere near as bad until I did private practice. Cause in hospital care I often times had a few hours to myself while writing up reports or conferring with colleagues in an honest manner, not in a manner where I had to where the hat of "guy who is not pissed off at you for malingering, grabbing that nurse's butt, and then demanding scrambled eggs with bacon."

This right here! Exactly how I feel. I have a lot of difficulty getting other people to understand this, including my wife. I cringe when I pull into my driveway and see my neighbor outside. I like the guy, but I just want to not be around people for a little bit to deflate from the day.

 

[whopper]

 

[thoffen]

"That'll be $300"

Quickie psychoanalysis:
"You wanted to have sex with your mother and kill your father. That'll be $100,000."

 

[clausewitz2]

Quickie psychoanalysis:
"You wanted to have sex with your mother and kill your father. That'll be $100,000."

"For a limited time, we can offer a special payment plan of $1,000 a week forever."

 

[whopper]

It also influenced my relationships because people want to hear my input on their lives, psychoanalyze politicians and other celebrities, etc.

I tell them I'm not supposed to do that when I don't know much about the person they ask me about.

 

[Attending1985]

I think it’s made me more intolerant to be truthful. I see more personality disordered traits that before I wouldn’t have recognized as such. On the flip side I think it’s helped me recognize and hopefully decrease some of my own stuff.

 

[SourceOfDenial]

I think it’s made me more intolerant to be truthful. I see more personality disordered traits that before I wouldn’t have recognized as such. On the flip side I think it’s helped me recognize and hopefully decrease some of my own stuff.

It's interesting that training makes you see behavior you saw before, but now makes you pathologize it. Not critiquing you, but seems like psychiatry training in general missed the mark somewhere if that's a key take away.

 

[Attending1985]

It's interesting that training makes you see behavior you saw before, but now makes you pathologize it. Not critiquing you, but seems like psychiatry training in general missed the mark somewhere if that's a key take away.

I guess I don't know why it's surprising or interesting that after studying personality you would pick this up in others in your personal life in a way you didn't in the past. I think the intolerance comes from burnout in dealing with it a lot at work. We are kidding ourselves if we think we are immune to this.

I would counter that the study of personality is lacking in psychiatry training and it's something that's extremely important to be knowledgeable about. Personality tends to come off as a dirty word but it is what it is and it's very relevant to what we do.

 

[st2205]

I think it’s made me more intolerant to be truthful. I see more personality disordered traits that before I wouldn’t have recognized as such. On the flip side I think it’s helped me recognize and hopefully decrease some of my own stuff.

I’ve become a miserable SOB through training. In many ways, I’m much less compassionate and no longer care about being misperceived. Obviously I’m hyperbolizing a bit but the sentiment is true. There’s a funny thing in our clinic with psychologists talking about how therapy starts at the front desk. I think that’s true. However, they say that more within the context of the front desk staff being warm and friendly. While that’s nice, even having bad experiences and learning to work through those is therapeutic, but we tend to focus mostly on the idea that being warm and loving is the only kind of healing available.

It's interesting that training makes you see behavior you saw before, but now makes you pathologize it. Not critiquing you, but seems like psychiatry training in general missed the mark somewhere if that's a key take away.

Are you a psychiatrist or in training? It’s not about pathologizing something where it doesn’t exist. It’s like a radiologist looking at a CXR and seeing a pneumothorax. It’s not that they’re trying to pathologize something where it isn’t there, it’s that they’re staring at a pneumothorax on a CXR. Or like anyone seeing AFib on an EKG. It does not require putting on a thinking cap and requires no conscious synthesis of information.

 

[Attending1985]

I’ve become a miserable SOB through training. In many ways, I’m much less compassionate and no longer care about being misperceived. Obviously I’m hyperbolizing a bit but the sentiment is true. There’s a funny thing in our clinic with psychologists talking about how therapy starts at the front desk. I think that’s true. However, they say that more within the context of the front desk staff being warm and friendly. While that’s nice, even having bad experiences and learning to work through those is therapeutic, but we tend to focus mostly on the idea that being warm and loving is the only kind of healing

Yes I believe therapy starts at the front desk as well. We should be warm and friendly and patients should behave appropriately. If not, it will definitely be discussed during my visit.

 

[whopper]

Here's a way you can screw with other people who KNOW YOU'RE A PSYCHIATRIST.

Whenever they do or say something, stare at them for about 10 seconds and slowly say, "I see....."

And then no matter what they do, again, coldly look at them don't say anything for about 10 seconds then repeat, "I see" but this time in a condescending and judgmental tone and make the word "see" into 2 syllables, like "see-uh."

Repeat over and over.

 

[SourceOfDenial]

Are you a psychiatrist or in training? It’s not about pathologizing something where it doesn’t exist. It’s like a radiologist looking at a CXR and seeing a pneumothorax. It’s not that they’re trying to pathologize something where it isn’t there, it’s that they’re staring at a pneumothorax on a CXR. Or like anyone seeing AFib on an EKG. It does not require putting on a thinking cap and requires no conscious synthesis of information.

I've completed formal training, yes.

The idea that the practice of psychiatry is as concrete as a radiologist or cardiologist reading a CXR or EKG is a nice idea, but a bit Pollyanna. Apart from depression secondary to hypothyroidism, dx of Alzheimer's with amyloid PET scan, and a few other illnesses--we do not have objective tests to diagnose the things we see and treat.

I think often psychiatry is about pathologizing, to the fields detriment. Sometimes our labels are either inaccurate, or pejorative such that they serve to further isolate the individual, or medicalize an experience to the degree that one feels compelled that a medical intervention is the only possible fix.

I say this as someone who practices in both psychiatric and non psychiatric settings I see individuals with near identical experiences get very different care, or approaches to treatment, once a psychiatric diagnosis is made. It frequently makes me wonder if psychiatrys quest to diagnosis actually serves the patient, or our own interests to be recognized as equal among our medical peers.

 

[smq123]

Here's a way you can screw with other people who KNOW YOU'RE A PSYCHIATRIST.

Whenever they do or say something, stare at them for about 10 seconds and slowly say, "I see....."

And then no matter what they do, again, coldly look at them don't say anything for about 10 seconds then repeat, "I see" but this time in a condescending and judgmental tone and make the word "see" into 2 syllables, like "see-uh."

Repeat over and over.

This is hilariously true.

When I was an intern (I'm family med), I was rounding on one of our patients in the hospital, who was an elderly, retired psychiatrist.

When I walked into his room, he commented, "Oh! You're wearing red shoes!"

I said something inane but pleasant, like, "Yeah, I just wanted to wear cheerful colors" or something like that.

He just grunted a "hmmmph" in response. Then he said, "I see" a couple of times.

So of course I spent that night googling, "Are red shoes a soft sign of mental illness?"

 

[deleted910552]

I know psychiatrist who switched from family physician to psychiatric field because he said he found it boring.

 

[Horners]

I've completed formal training, yes.

The idea that the practice of psychiatry is as concrete as a radiologist or cardiologist reading a CXR or EKG is a nice idea, but a bit Pollyanna. Apart from depression secondary to hypothyroidism, dx of Alzheimer's with amyloid PET scan, and a few other illnesses--we do not have objective tests to diagnose the things we see and treat.

I think often psychiatry is about pathologizing, to the fields detriment. Sometimes our labels are either inaccurate, or pejorative such that they serve to further isolate the individual, or medicalize an experience to the degree that one feels compelled that a medical intervention is the only possible fix.

I say this as someone who practices in both psychiatric and non psychiatric settings I see individuals with near identical experiences get very different care, or approaches to treatment, once a psychiatric diagnosis is made. It frequently makes me wonder if psychiatrys quest to diagnosis actually serves the patient, or our own interests to be recognized as equal among our medical peers.

Do you think the practice of psychiatry doesn’t add value to a patient’s QoL? Can you provide a concrete example? Furthermore, do you think this is an a priori fact of practice or do you think there’s a lot of bad practice/training floating out there?


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[erg923]

Do you think the practice of psychiatry doesn’t add value to a patient’s QoL? Can you provide a concrete example? Furthermore, do you think this is an a priori fact of practice or do you think there’s a lot of bad practice/training floating out there?


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Of course it does/can. But alot of times psychiatry/psychiatric medicine is the last thing a person needs and often the first call that is made. Poverty, grief, medical treatment resistance, bad/unlawful behavior, ego-dsystonic conditions, just to name a few.

For example, the practice of medicating ODD (it happens), which is usually environment/psycho-social stressors and parenting, or both. Sometimes its a response to terrible situations. Sometimes its just temperament and stubbornness. Sometimes its age appropriate behavior. I dont think this is mental illness.

Recently, AD/HD also has become some kind of "catch all" for kids who do not conform, IMHO. Especially within the low-income and medicaid populations.

And, not really relevant to psychiatry/psychiatrists, but why are learning disorders in the DSM as "mental illness/disorder?

 

[Attending1985]

I've completed formal training, yes.

The idea that the practice of psychiatry is as concrete as a radiologist or cardiologist reading a CXR or EKG is a nice idea, but a bit Pollyanna. Apart from depression secondary to hypothyroidism, dx of Alzheimer's with amyloid PET scan, and a few other illnesses--we do not have objective tests to diagnose the things we see and treat.

I think often psychiatry is about pathologizing, to the fields detriment. Sometimes our labels are either inaccurate, or pejorative such that they serve to further isolate the individual, or medicalize an experience to the degree that one feels compelled that a medical intervention is the only possible fix.

I say this as someone who practices in both psychiatric and non psychiatric settings I see individuals with near identical experiences get very different care, or approaches to treatment, once a psychiatric diagnosis is made. It frequently makes me wonder if psychiatrys quest to diagnosis actually serves the patient, or our own interests to be recognized as equal among our medical peers.

I would emphatically agree that axis 1 disorders are overdiagnosed and are often inaccurate and the stigma of mental illness will definitely effect medical treatment negatively.

I think what others and myself are referring to is not observing someone and labeling them with gad, mdd, bipolar disorder but recognizing unhealthy adaptations in behavior that don’t constitute a psychiatric diagnosis but are much more relevant to the patient’s dysfunction than any psychiatric diagnosis. I think recognizing this leads the less over diagnosis and medical treatment of essentially problems of emotions/living.

 

[Jules A]

It did help tremendously, though, when I had to re-enter the dating pool. I'm so very thankful for the unfair advantage I had to identify red flags and run far, far away.

You are insightful. Excluding those who were stupid enough to enter into inappropriate patient relationships I know more than a few good psychiatrists who nonetheless succumbed to a gorgeous borderline. Although my anecdotal examples are all first wives and I suspect there is a higher rate of this condition across the board in first marriages anyway. 😀

 

[DD214_DOC]

I found a really fun response to the, "Oh, are you analyzing me right now?", statement 9/10 people make when they find out what I do. My response now is, "Yes, but I've learned to keep it to myself".