Performance-oriented niche?

[Nasrudin]

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I'm interested in performance psychology, flow states, and peak performance and psychology work along these lines.

Do any of you know a psychiatrist who developed a niche in maximizing human performance and potential, perhaps while using our training to help clients cope with underlying psychiatric problems in the process?

 

[PikminOC]

I know sports Psychiatrists who do exactly what you are saying.

 

[Nasrudin]

I know sports Psychiatrists who do exactly what you are saying.

Hmmm. Any thoughts on how to develop the niche?

 

[whopper]

know sports Psychiatrists who do exactly what you are saying.

And I hope those psychiatrists are utilizing real evidenced based data in their practice and not further espousing the mystique that psychiatrists are actually akin to Jedi Knights. I sometimes am told by patients that they are disappointed I cannot read their mind and had an expectation I could do so.

I usually respond that if I could do that, I would be spending at least 20 hours a week in a casino.

Psychiatry is the use of medical science to treat mental illness. No where in our training do we get education on maximizing sports performance. Some of what we learn may be able to help performance but if a psychiatrist were to work in that area, we need to lay it on the table just exactly what we can do and what we cannot do.

This reminds me of all those doctors in the movie The Kings Speech that didn't know WTF they were doing while they were shoving marbles in the King's mouth hoping to cure him of his stuttering, or the case of David Reimer
http://en.wikipedia.org/wiki/David_Reimer
who survived a botched circumcision and his family was instructed by a psychologist to make him into a female because he had an erroneous idea that gender identity is learned from society (while not factoring in that genetics and intrauterine events likely play a more signifcant role). Those doctors were operating on a narcissistic and egocentric assumption that because they were learned men, they were right. Anyone can come up with a hypothesis. Many of them turn out to be completely off when tested in real-life.

Just because one is a doctor does not mean you know everything. This is in no way directed at you Nasrudin. I'm think that because you are interested in this means you are the thinking sort that wants to pursue your intellectual passions. I'm just saying don't fall into the narcissistic trap that some other doctors have.

Maximizing performance? The area of Industrial Psychology specializes heavily in this. One could, for example, read up on it on their own but without a degree in this specific area, there could be a poseur factor here. Being highly trained in psychotherapy could likley help the phenomenon some athletes go through with self doubt and performance anxiety.

 

[Nasrudin]

And I hope those psychiatrists are utilizing real evidenced based data in their practice and not further espousing the mystique that psychiatrists are actually akin to Jedi Knights. I sometimes am told by patients that they are disappointed I cannot read their mind and had an expectation I could do so.

I usually respond that if I could do that, I would be spending at least 20 hours a week in a casino.

Psychiatry is the use of medical science to treat mental illness. No where in our training do we get education on maximizing sports performance. Some of what we learn may be able to help performance but if a psychiatrist were to work in that area, we need to lay it on the table just exactly what we can do and what we cannot do.

This reminds me of all those doctors in the movie The Kings Speech that didn't know WTF they were doing while they were shoving marbles in the King's mouth hoping to cure him of his stuttering, or the case of David Reimer
http://en.wikipedia.org/wiki/David_Reimer
who survived a botched circumcision and his family was instructed by a psychologist to make him into a female because he had an erroneous idea that gender identity is learned from society (while not factoring in that genetics and intrauterine events likely play a more signifcant role). Those doctors were operating on a narcissistic and egocentric assumption that because they were learned men, they were right. Anyone can come up with a hypothesis. Many of them turn out to be completely off when tested in real-life.

Just because one is a doctor does not mean you know everything. This is in no way directed at you Nasrudin. I'm think that because you are interested in this means you are the thinking sort that wants to pursue your intellectual passions. I'm just saying don't fall into the narcissistic trap that some other doctors have.

Maximizing performance? The area of Industrial Psychology specializes heavily in this. One could, for example, read up on it on their own but without a degree in this specific area, there could be a poseur factor here. Being highly trained in psychotherapy could likley help the phenomenon some athletes go through with self doubt and performance anxiety.

Thanks. I'm just tinkering around in my head with things that interest me. I'm kind of a futurist/science fiction fan as well. And like to imagine a role for psychiatrists in the augmentation of the human mind with technologies. I guess just hobby like interests that I'm curious if anyone is pursuing.

But yeah. I'll try to avoid starting a cult. Unless it involves me getting rich and perpetually laid. In which case, my apologies ahead of time.

 

[F0nzie]

Psychopathology is present in athletes just like any other group. ie. depression, anxiety, TBI (maybe more in athletes), substance abuse, etc. By the same reasoning you could also create a niche called "Business Psychiatry" where you specifically help CEO's "maximize their performance" and company profitability by treating underlying psychopathology and it would be no different.

 

[whopper]

Thanks. I'm just tinkering around in my head with things that interest me. I'm kind of a futurist/science fiction fan as well. And like to imagine a role for psychiatrists in the augmentation of the human mind with technologies.

Same here, and I too had similar thoughts in medschool and residency.

There is a difference with getting someone's performance better via treating their mental illness vs someone without mental illness and working on changing life-paradigms to get them to perform better. The latter is something outside of psychiatry. The former, however, if you clarify that your box is within treating mental illness, that IMHO could work.

Just to give a little bit of an example, corporations often times hire industrial psychologists to see if there's something to do to increase workplace efficiency. The cubicle is a result of this type of intervention. We dont get training in this area. No psychiatrist I know of can identify what the Hawthorne Effect is but that is bread and butter in industrial psychology.

 

[Leo Aquarius]

I worked in a fortune 500 business prior to med school and can relate to the challenges of business psychology more than many psychologists. I may go into business psychiatry/psychology. I don't need to be a psychologists to know how to train business folk and frankly I don't mind that it has nothing to do with psychiatry.

 

[shan564]

Ron Artest/Metta World Peace will respond to lithium the same way as every other patient. And the New York Knicks will be forever indebted to the first psychiatrist to prove that.

 

[PikminOC]

It was my former program director and he is very much evidence based.

 

[¯\_(ツ)_/¯]

interesting thread. while i can see a psychiatrist doing the sports performance enhancement niche, from the perspective of the employer, what does a psychiatrist bring to the plate that a psychologist doesn't (assuming real psychopathology in the athletes have a prevalence rate similar to the normal population which is to say not much)?

 

[Leo Aquarius]

an M.D.

Who knows the body better than a medical doctor? I can sell that to any employer easy. And by knowing physiology I can say I understand XYZ better than .... you get the idea.

Ask me in 3 years and I'll tell you how this goes...

 

[¯\_(ツ)_/¯]

most half-decent sports teams have a physician(s) already. i think it might be difficult to sell that you'd be able to deliver better team/individual performance because you understand physiology better when the job description would most likely be to keep the athletes motivated and focused and in top shape mentally, and the team cohesive

 

[Leo Aquarius]

If I charged the same price, then I'd have a distinct advantage. A motivationalist with an M.D at the same price as one without who can handle the occasional above-and-beyond situations that may benefit from prescriptions if needed just in case. That's a no-brainer. Traditionally speaking, team doctors are folks like ortho guys. They just do sports medicine. I'm not traditional, and would offer something different.

 

[LisaLou]

Bit of a tangent here....

Technically, we do have the ability to boost performance outside of just treating psychopathology. For example, I would suspect giving Adderall to an accountant with no psychopathology would likely boost his or her productivity. I would certainly never do this, as my gut reaction is that this is bad practice and unethical. However, I have prescribed modafinil etc. for shift work sleep disorder, and when you get right down to it, what's the real difference? As I view it, there's not an inherent psychopathology to shift work sleep disorder, it's simply an inability of the body to meet the demands of the person's employer. What then is the real difference between that and the accountant who comes in saying that to keep his job, he must edit 30 spreadsheets an hour, which he can't do without being on a stimulant?

(Again, not trying to justify anything, just curious about what ethical arguments people would make)

 

[Shikima]

I'd make the ethical arguement that in treating shift work disorder you have a circadian misalignment and psychoeducation coupled with stimulants may be an appropriate direction to go in.
A similar arguement could be this; Some guy presents to your clinic with complaint of an inabilty to concentrate and jumps between topics in conversation. You diagonse him with ADHD, prescribe a stimulant as this is the practice method in treating these disorders, and had not completely evaluated his sleep patterns or other mood/anxiety stressors.

May want to consider doing a sleep medicine elective.

 

[shan564]

Also addiction potential.

 

[whopper]

As I view it, there's not an inherent psychopathology to shift work sleep disorder, it's simply an inability of the body to meet the demands of the person's employer. What then is the real difference between that and the accountant who comes in saying that to keep his job, he must edit 30 spreadsheets an hour, which he can't do without being on a stimulant?

A legal difference is some insurances will not pay you if you aren't treating pathology. Making a person perform better is not considered treating pathology.

Okay, so one could then be cash-only.

Malpractice follows the same pitfalls. A malpractice company has specifics on what they cover, and if you are not practicing within the guidelines of your field, they may refuse to cover you. Can a medical doctor practice if you don't have malpractice insurance?

You could avoid that pitfall if you declare openly that your MD and your psychiatric training doesn't focus on performance enhancement. It could indirectly help, but you are not truly a specialist in a manner that may be recognized by others in the field of psychiatry of the area of what you are practicing.

Can a doctor do surgery? Yes. Can a psychiatrist say they are an expert in sports performance enhancement without any specific training in that area? Yes. Are there ethical and legal problems and ambiguities with doing it? Yes.

I'm not saying one cannot do the above. I just said one could. Just like a doctor could open an "anti-aging" clinic, charge patients $1000 for an intiial evaluation and simply tell the patient they need to excercise, take antioxidants, lower their cholesterol, and pretty much do anything a PCP could've done. Is it outstanding practice? Is it ethical?

I worked in a fortune 500 business prior to med school and can relate to the challenges of business psychology more than many psychologists. I may go into business psychiatry/psychology. I don't need to be a psychologists to know how to train business folk and frankly I don't mind that it has nothing to do with psychiatry.

I don't know if this will cover you. There is an administrative psychiatric board certification you can get. It requires one year of something that could be consdered a "leadership" experience such as being a program director, a chief resident, but working in business may count. You simply have to pass an exam , have the 1 year experience thingee, and pass the exam.

 

[LisaLou]

Whopper, I totally get what you are saying. I'm just still stuck on why the inability of a person's circadian rhythm to match the needs of their employer is considered a diagnosable pathology, while the inability of a person's attention span to match the needs of their employer is not. If anything, I would argue that treating shift work sleep disorder is essentially performance-enhancing, we just happen to have an FDA indication to back it up.

 

[michaelrack]

Whopper, I totally get what you are saying. I'm just still stuck on why the inability of a person's circadian rhythm to match the needs of their employer is considered a diagnosable pathology, while the inability of a person's attention span to match the needs of their employer is not. If anything, I would argue that treating shift work sleep disorder is essentially performance-enhancing, we just happen to have an FDA indication to back it up.

Both shift work sleep disorder and ADHD are defined, in part, by inability to maintain sufficient alertness/attention for an employer (or educator). The boundary between pathology and "lower limits of normal" are a little bit fuzzy

 

[Shikima]

Whopper, I totally get what you are saying. I'm just still stuck on why the inability of a person's circadian rhythm to match the needs of their employer is considered a diagnosable pathology, while the inability of a person's attention span to match the needs of their employer is not. If anything, I would argue that treating shift work sleep disorder is essentially performance-enhancing, we just happen to have an FDA indication to back it up.

To use a parallel analogy, we know that teenager circadian rhythms are altered to start later and end later in the day. Yet we persist in maintaining that they need to start school at 7-8am 5 days a week. We throw medications at them because they're not able to stay awake and maintain attentiveness under labelling and diagnosis, all with FDA approval.

 

[whopper]

Agree on the fuzzy part.

Hey, one could do be a psychiatrist and claim they can fix marriages despite that we get no training whatsoever in marital therapy. You could do surgery too.

I wouldn't.

I know some psychiatrists that do marital therapy but they got extra training in it, so in their cases, I wouldn't see anything wrong with it.

I would be willing to treat the sleep-work disorder because it's an accepted pathology with an accepted treatment that's been accepted by professional societies, insurance companies, and several other entities. You could read up on it from several sources and be up to speed.

Compare that to this case...
http://en.wikipedia.org/wiki/Candace_Newmaker

Where a therapist did a type of therapy she likely made up on her own without it having any real foundation in accepted practice and science behind it.

I'm actually saddened to see the number of people here on the forum in the last few months stating they want to do practices that have no good data to support it such as the Ketamine clinics that appear to be sprouting up or people thinking they can do performance "therapy" despite having no training it in whatsoever.

 

[Ceke2002]

I'm interested in performance psychology, flow states, and peak performance and psychology work along these lines.

Do any of you know a psychiatrist who developed a niche in maximizing human performance and potential, perhaps while using our training to help clients cope with underlying psychiatric problems in the process?

I'm pretty sure my Psychiatrist does workplace training seminars to improve peak performance rates within the health profession community (not necessarily confined to the mental health sector) using metacognitive, mindfulness based principals and therapies. Might be something you could look at doing as well, lot of corporations looking to maximise productivity and performance, I'd hazard a guess at least.

 

[whopper]

I've read up on the administrative psychiatry certification. It seems to be more so for being a psychiatric administrator such as a director or head of a dept. I don't think it has to do with actually improving performance in business.