self preservation

[MSc44]

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For all you physicians

specializing in psych i imagine can be mentally and emotionally draining, what techniques do you guys and gals do to keep your sanity or yourself from becomming a patient....seriously

 

[Poety]

In all honesty I don't know where the whole idea comes from that if you're working with the mentally ill, you'll be any more drained or exhausted as say working as a heme-onc/endo/cardio - I find those specialties to be just as exhausting since the patients are usually once again, chronic (or even terminal)

I imagine its just having the ability to leave work at work and keeping yourself healthy (which you should do in ANY specialty) I can see the concern since theres so much therapy in psych, but thats not the only option either - plus, if you consider this your job, not your identity, its easy to separate and not let the patients drain on you too much (especially once they teach you these skills, which is CRUCIAL!)

If you're considering psyc, good luck! Welcome to our forum 🙂

 

[Psyclops]

Can you consider beinga physician or in my case psychologist "just a job'?

 

[50960]

You have to psyclops. There is a boundary there. I agree with Poety.

 

[Psyclops]

Well, sure you would want there to be some sort of disconnect, but "just a job" seems a little dismissive. No?

 

[OldPsychDoc]

I'd say it tends to work the opposite direction more often for me.
That is, if I'm having a bad day at home (Hey, I've got teenagers!) I REALLY don't feel very enthusiastic about facing 8 hours of whiny, needy people at work too. But I have good relationships with my colleagues and we can do a lot of "back room venting". It gets us through the day, we help people, and usually no one gets hurt. My students and residents help me stay enthusiastic about my work, too.
Also, in real life it also really helps to have a strong network of "normal people"--e.g non-patients AND non-health professionals--that you can do things with socially, etc. It can be nice to just have a beer on the deck with a neighbor, or go to church, or watch a ball game, etc.

 

[Poety]

Well, sure you would want there to be some sort of disconnect, but "just a job" seems a little dismissive. No?

But it IS just a job - it's definitely not my life. Although I have a career that requires an enormous amount of dedication and time, it doesn't by any means define who I am as a person (except ofcourse when I'm looking for the privs of being a doc HAHAHAHAHAHA THEn and ONLY THEN does it define me 😛 )

 

[Anasazi23]

House of God summarized in some sort of way (I'm paraphrasing):

Being a physician is a job. An very important job...but still a job.

 

[Psyclops]

I guess, for me at least, I think it would define me to a certain extent. I would have a hard time with it not, seeing as it takes up some much time, any job does, and it took up so much time and effort to get there. But, I also find it very interesting, so it is inextricable from my intrests. Although I hope I never turn into those people who are unable to seperate themseles from it ever. Being adicted to this doesn't help though.

 

[Triathlon]

I'd say it tends to work the opposite direction more often for me.
That is, if I'm having a bad day at home (Hey, I've got teenagers!) I REALLY don't feel very enthusiastic about facing 8 hours of whiny, needy people at work too. But I have good relationships with my colleagues and we can do a lot of "back room venting". It gets us through the day, we help people, and usually no one gets hurt. My students and residents help me stay enthusiastic about my work, too.
Also, in real life it also really helps to have a strong network of "normal people"--e.g non-patients AND non-health professionals--that you can do things with socially, etc. It can be nice to just have a beer on the deck with a neighbor, or go to church, or watch a ball game, etc.

This is the second reference to your kids in the last two days.

Well, um, sorry but...um, I'm a dad, so uh...
...well, there are times that my kids make me long for the relative peace and quiet of a psych ward...

Is there something we can help you with? 😉

 

[OldPsychDoc]

This is the second reference to your kids in the last two days....
Is there something we can help you with? 😉

You know any good long-term, year-round boarding schools?

 

[Doc Samson]

Can you consider beinga physician or in my case psychologist "just a job'?

This is where the whole "job vs. profession" thing gets started. We definitely fit the "official" definition of a profession (self-governing, specific ethical standards, specialist skills/knowledge), but more than that, it is something you can't turn off. I'm guessing that when a supermarket cashier goes home, they stop being a cashier... they don't open the fridge, reach for a snack, ant think "$1.99 on sale." We can't turn off being/thinking/talking like shrinks (just look at the non-profession related discussions on this board), we always think about motivations, dynamics, Sazi's dancing phalluses... I mean dancing bananas. I don't advocate "bringing the office home" by any means, but I think it's near impossible to stop being a psychiatrist (or psychologist) just based on your geography.

 

[Psyclops]

This is where the whole "job vs. profession" thing gets started. We definitely fit the "official" definition of a profession (self-governing, specific ethical standards, specialist skills/knowledge), but more than that, it is something you can't turn off. I'm guessing that when a supermarket cashier goes home, they stop being a cashier... they don't open the fridge, reach for a snack, ant think "$1.99 on sale." We can't turn off being/thinking/talking like shrinks (just look at the non-profession related discussions on this board), we always think about motivations, dynamics, Sazi's dancing phalluses... I mean dancing bananas. I don't advocate "bringing the office home" by any means, but I think it's near impossible to stop being a psychiatrist (or psychologist) just based on your geography.

Well put, I hadn't heard of the job v. profession distinction, but that was exactly what I was getting at. I think in these professions, and others such as lawyers, engineers, career military, etc. you learn (are indoctrinated) to think about the world and approach problems and situations (people?) in a certain way. That doesn't just turn on or off IMO.

 

[Triathlon]

I completely agree with you about not being able to separate ourselves from our professions, but we really need to separate ourselves from our "jobs" I mean we shouldn't be at home thinking about Mr. Jones' psychotic episodes being related to the lunar orbits, or how that one nurse in the ER always seems to need something in the exam room when you are doing a consult. Of course that is the simple part. I think the OP may be asking how we leave the emotionality of our work at work. "Will our 17 y.o. female Dependant PD who just moved in with her 30 y.o. boyfriend really get pregnant on purpose hoping that will stop the abuse?" Basically how do we shut off the emotional concern temporarily while at home?
I don't have an answer to that yet. Anyone else?

 

[Psyclops]

Stigmatize 'em.

 

[Psyclops]

In all seriousness though, could the stigma of MI be a collective countertransference?

 

[Anasazi23]

Basically how do we shut off the emotional concern temporarily while at home?
I don't have an answer to that yet. Anyone else?

I don't seem to have a problem with this. Only rarely does a case truly make me feel uneasy enough; either that I did something wrong and the patient will be harmed, or that a situation is truly awful, that I would actively think about this at home.

Hobbies are great. I've got lots.

 

[Poety]

I don't seem to have a problem with this. Only rarely does a case truly make me feel uneasy enough; either that I did something wrong and the patient will be harmed, or that a situation is truly awful, that I would actively think about this at home.

Hobbies are great. I've got lots.

I actually disagree with DS on this one and COMPLETELY agree with Sazi. I have a full life, full of CN, my new house, my new environment, friends, people around, etc etc. Yeah, ofcourse I get the advice about what about so and so because of odd behavior, but for the most part, we talk about things like, what our children are doing, what car we bought, what color we painted the house, etc etc etc (oh, and beers are ALWAYS involved shut up, it doesn't need a diagnosis!) but my point is, theres a time and place to worry about x,y,z, and home is NOT it.

I enjoy being home, I have friends that are residents, we don't talk about medicine and whats going on in MEDICINE or PSYCh, we talk about our LIVES - which is the distinction between letting a career define you vs. letting it be just an aspect of who you are as a person.

The day I go home and neglect my little one for the sake of worrying excessively about a patient is the day I need to get some therapy myself.

Like Sazi said - if its not something I'm should be worried about like hurting someone, I should be spending my home time at home. This is not to say that I should not have time set aside to study on my own, and to learn about my patients when not in clinic - what I'm saying is, HOME TIME SHOULD BE HOME TIME!

I segregate a part of each day, even now when I'm on vacation to stay connected to my career - if I didn't, I wouldn't be prepared at all, but for the most part, this IS a vacation - and I'm enjoying it. Time off is just that, time you are not seeing patients, time you are to replenish yourself. If you lose that, in the long run you will get burned out - and end up with a broken marriage, household and lack of support which ultimately we all need.

 

[Anasazi23]

I think that's a good attitude, Poety.

But, I do understand what DS is saying also. Since a large portion of our lives deals with the human interaction, you can't help but to have a unique or specialized view of someone's behavior, whether it's in conversation, or a family member who has screwed up again.

And since we are physicians, I do tend to think of medical consequences quite often when I'm walking down the street and see a homeless person with raging cellulitis and CHF lying on the sidewalk.

For good or bad, however, these thoughs usually quickly pass and I'm off into another.

I'd be lying if I said that I don't talk about work with my friends (many of whom are residents) - especially the ones from the same hospital. But, the large majority of our conversations are NOT about medicine....and we like it that way.
🙂

 

[Poety]

Thanks Sazi,

I do the same thing, especially when I see behaviors indicitive of some pathology, but I think anyone with any career does that (applies it to their job) when they can! I don't think thats unique to us at all do you?

 

[Psyclops]

I don't think it is. Some people make it more or less public by prefacing their comments with things like "Well, since I'm an architect...." But, for those in psych, the funny thing is that we posessspecialized knowledge about so much that is mundane and what people like to talk about anyway, namely, other people.

 

[Poety]

I don't think it is. Some people make it more or less public by prefacing their comments with things like "Well, since I'm an architect...." But, for those in psych, the funny thing is that we posessspecialized knowledge about so much that is mundane and what people like to talk about anyway, namely, other people.

I cringe at the thought of having to tell anyone what my specialty is. In fact, I'm considering starting to lie and saying "surgery" that way I won't get the whole, OH YOU WOULD KNOW THIS THEN, WHAT ABOUT MY BROTHER WHO.. BLAH BLAH BLAH,,,,, drugs,,, bLAH blah blah....... is he bipolar? blah blah blah, oh and my boyfriend...... 🙄 🙄 🙄

 

[Psyclops]

Yeah, that's for sure, that can get really anoying. But I meant in terms of our own personal outlook on the world.

 

[Doc Samson]

In all seriousness though, could the stigma of MI be a collective countertransference?

Absolutely. Not to mention the stigmatization of psychiatrists. People belittle what they fear, and they fear what they do not understand.

BTW Poety, I think we agree more than disagree on this. Like I said I don't advocate "bringing the office home." I rarely think about my patients outside of the work setting, unless they're in crisis and are paging me (or the ED is paging me) at night/on the weekend. I just think that we carry our professional ethics/beliefs/skills with us no matter where we go. If I'm on a plane and they ask if there's a doctor on board, of course (after a moment of panic) I raise my hand, I don't think to myself "hmm, I'm a "civilian" on vacation right now, so no, I'm not a doctor", and I don't think you would either. Thus, we can't completely "leave it behind" when we step outside of the hospital.

 

[Poety]

Absolutely. Not to mention the stigmatization of psychiatrists. People belittle what they fear, and they fear what they do not understand.

BTW Poety, I think we agree more than disagree on this. Like I said I don't advocate "bringing the office home." I rarely think about my patients outside of the work setting, unless they're in crisis and are paging me (or the ED is paging me) at night/on the weekend. I just think that we carry our professional ethics/beliefs/skills with us no matter where we go. If I'm on a plane and they ask if there's a doctor on board, of course (after a moment of panic) I raise my hand, I don't think to myself "hmm, I'm a "civilian" on vacation right now, so no, I'm not a doctor", and I don't think you would either. Thus, we can't completely "leave it behind" when we step outside of the hospital.

True, but admit it, you dont WANT to raise your hand right? I always wait to see if someone else will first

 

[Anasazi23]

I have to admit, that particularly when I'm on the inpatient unit, there are days where I just feel like throwing up my hands, saying f___ it, f___ all of you entitled, personality-disordered people....I'm outta here.

Then again, I'm pretty sure inpatient might not be for me. Others, including OPD, tell me it's much better when you're an attending, running the show, and have others doing "the heavy lifting."

Still, I envision myself doing very little inpatient stuff. I don't like the hospital atmosphere, the administrative bullcrap, and endless paperwork and bureaucratic nonsense that is directed at PC placation rather than true patient care.

 

[50960]

amen.....sazi. 🙂