Why do Psychiatrists always try to “analyse” others

[DrMEyeA]

---

Members don't see this ad.

First off let me begin by saying that I’m a general resident in Australia who is aiming to start psychiatry training next year.

But one thing that always puts me off is the behaviour of psychiatrists and psychiatry registrars. They always try to “analyse” people and in a somewhat toxic manner. Im not talking about patients, but other collegues doctors, nurses and even at a dinner, the patrons.

I find it somewhat odd and they do it in a way as if they are putting the other person down?

It just worries me because if that’s the culture of the career I don’t want to end up like those kind of people.

 

[docksan]

I'm a psychiatrist, and I don't do that. Neither do most of my colleagues.

 

[nexus73]

You might just be misreading weird psychiatrists who are socially awkward.

 

[robellis]

This is not normal for psychiatrist that I know, I think you need to meet new/not weird people/friends

 

[Bartelby]

Confirming all of the above, that isn't typical.

 

[DrMEyeA]

Just to reiterate, these aren’t my friends. They are collegues that I work with. For instance I’ll consult on the psych reg, state X nurse has reviewed the patient and their assesment is Y which I agree. Then they’ll make an offhand comment that X is so NPD or what ever personality cluster. I find it quite unprofessional and uncomfortable.

How else should I interpret or read a situation when people say things like that?

 

[robellis]

Just to reiterate, these aren’t my friends. They are collegues that I work with. For instance I’ll consult on the psych reg, state X nurse has reviewed the patient and their assesment is Y which I agree. Then they’ll make an offhand comment that X is so NPD or what ever personality cluster. I find it quite unprofessional and uncomfortable.

How else should I interpret or read a situation when people say things like that?

You should realize that the person saying that likely has their own issues and is not representative of the field as a whole and try to get out of that environment as soon as possible and if a resident suck it up and act nicely/professionally in the mean time

 

[docksan]

Just to reiterate, these aren’t my friends. They are collegues that I work with. For instance I’ll consult on the psych reg, state X nurse has reviewed the patient and their assesment is Y which I agree. Then they’ll make an offhand comment that X is so NPD or what ever personality cluster. I find it quite unprofessional and uncomfortable.

How else should I interpret or read a situation when people say things like that?

Maybe find a larger sample size than 3 people.

 

[Liquid8]

I don’t think this is common, although one will probably be able to make accurate observations on various aspects of personality or mental health with more experience and time. The wisdom to choose whether to divulge those observations is another matter entirely.

Just to reiterate, these aren’t my friends. They are collegues that I work with. For instance I’ll consult on the psych reg, state X nurse has reviewed the patient and their assesment is Y which I agree. Then they’ll make an offhand comment that X is so NPD or what ever personality cluster. I find it quite unprofessional and uncomfortable.

How else should I interpret or read a situation when people say things like that?

Sometimes snarky comments about peers may be the tip of the iceberg.

In the situation described I take it you’re referring a patient to a CL registrar, which as far as Australian psych job goes is much busier and prone to more poor quality referrals. This isn’t to say you’ve done a poor job with the referral, but in this role it’s not uncommon to receive referrals from disinterested medical officers who haven’t bothered to speak to their patients and are only making the referral because someone non-medical is driving the process. Unlike med/surg registrars who are rostered to take referrals and can delay bad ones to another day when someone else can deal with it, in CL psychiatry it’s usually the same individual for a six month period so it can get frustrating.

When registrars do their CL term they often struggle, as they may have become accustomed to no-shows and long lunches in the community clinics or have failed to recognise the differences that enable one to “survive” on the acute inpatient ward. As psych inpatients wards have a fixed bed capacity, there is no reward for discharging patients quickly. Discharge 5 in one day and you’ll have 5 new patients the next day that need to be worked up. In contrast stagger discharges at 1 a day over the next 5 days, and the patient flow becomes more manageable. The latter approach doesn’t work in CL jobs which have more in common with the average medical job in that one has to be efficient with assessments and discharges as the workload can pile up very quickly.

 

[TexasPhysician]

I can’t speak to Australia. In the USA, I’d say maybe 5% of psychiatrists do this, and my number may be high due to the presence of a psychoanalytic institute within driving distance.

 

[NickNaylor]

As with all groups of people, some psychiatrists are weird - maybe a greater proportion compared to the general population. That said, I certainly don't "analyze" people - I don't even know what that means - and I don't know anyone who intentionally does. But theoretically being an "expert" on human behavior and how people approach the world is obviously going to have an impact on how you interact with and perceive others.

 

[Mass Effect]

You might just be misreading weird psychiatrists who are socially awkward.

Or psychiatrists with personality disorders. We had one like this in residency in the class above me. And no, not analyzing him but making an observation that this type of behavior is textbook for something in the DSM. He used to do it behind people's backs, but he'd do it. Usually to get attention or invite comments about how knowledgeable he is or good at his job he is (he wasn't). Took a few talks from the PD to shut that down fast.

 

[Old&InTheWay]

It's grossly unprofessional to make comments about your colleagues' personalities to other colleagues. But it is hard to avoid noticing certain things. For instance, your use of the word "always" in the thread title makes me wonder whether you tend to see the world in black and white, rather than shades of grey. But I certainly would never comment on this publicly.

 

[Evidence Based]

I leave work at work, the last thing I want to do with my friends or family is "analyze" them. Does an accountant ask to see his friend's bank statements at a party? I'm off the clock!

 

[hebel]

Sounds like gossip (which many humans do), but with fancy psych terms.

This instance probably has more to do with the person being a yenta, than being a psychiatrist.

 

[FlowRate]

But theoretically being an "expert" on human behavior and how people approach the world is obviously going to have an impact on how you interact with and perceive others.

I find it taxing to be "on" like that all the time. I've met people who do manage to be that way and it seems to serve them well in terms of being like hyper career-focused and networking efficiently etc.

 

[deleted1100659]

Tbh, i thought the OP was trolling. Everyone judges everyone else to a certain degree. Some people are just more vocal about it. You are overgeneralizing, if the post is an actual question. You cant apply subjective experiences with some people to a broad group of people as obviously not all psychiatrists are the same.

 

[watto]

OP, I sense you may be projecting based upon your experience being forced to dress in your grandmother's clothes for Thanksgiving and made to ask "pass the cranberry sauce" in an old lady voice. No one deserves to be beaten with a chafing dish.

 

[PsyDr]

OP, I sense you may be projecting based upon your experience being forced to dress in your grandmother's clothes for Thanksgiving and made to ask "pass the cranberry sauce" in an old lady voice. No one deserves to be beaten with a chafing dish.

He's Australian. They don't celebrate Thanksgiving.

Tell me more about projecting.

 

[clausewitz2]

OP, I sense you may be projecting based upon your experience being forced to dress in your grandmother's clothes for Thanksgiving and made to ask "pass the cranberry sauce" in an old lady voice. No one deserves to be beaten with a chafing dish.

It's equally clear, however, that OP was allowed to use wire hangers, fortunately for their psychosexual development.

 

[calvnandhobbs68]

He's Australian. They don't celebrate Thanksgiving.

Tell me more about projecting.

Ah even more clarity, no wonder it stunted OP's development so much! This was clearly so traumatic that it's been repressed until now.

 

[erg923]

He's Australian. They don't celebrate Thanksgiving.

Tell me more about projecting.

They eat Kangaroos down der, ya dummy! This is not a racist statement...

 

[Osminog]

Then they’ll make an offhand comment that X is so NPD or what ever personality cluster. I find it quite unprofessional and uncomfortable.

I’ve met a couple of psychiatrists who love to casually assign personality disorder clusters to everybody—patients they haven’t yet talked to, political figures, hospital employees… “Wow, he said that? Sounds very Cluster B.”

When you start putting people into boxes so haphazardly, you may as well be functioning as an astrologer.

 

[adiradirim]

I’ve met a couple of psychiatrists who love to casually assign personality disorder clusters to everybody—patients they haven’t yet talked to, political figures, hospital employees… “Wow, he said that? Sounds very Cluster B.”

When you start putting people into boxes so haphazardly, you may as well be functioning as an astrologer.

Wow. Sounds very Virgo...

 

[DrMEyeA]

Jesus Christ. Okay I just want to say. Some of the comments are the funniest I’ve read, you guys have a good sense of humour which makes me feel at ease that I’ll fit in and found my tribe haha.

I think I’ve just met a select few of burnt out regs.

And by the way I passed my interview and have been offered a job! Yippee.

DM me if you want a junior psych reg to project their feelings and analyse you 🙂

 

[DrZoidberg17]

Relevant XKCD:

Alt text: "This is something we all need to work on, but especially you all."

 

[whopper]

I've found that among most of, at least the Americans, psychiatrists aren't much better at analyzing people because their own objective skills in this area wasn't significantly trained. Forensic studies show that psychiatrists don't know more about reading people than laymen in many regards.

I tell this to patients. I only can tell what I see in my office and what you tell me. I don't have a private detective following you. I don't do forensic testing unless it's a forensic case. If you're an alcoholic, come into my office sober, or at least acting sober and not looking drunk and you tell me you're not drinking I won't be able to tell if you are vs you aren't.

Psychiatry has become much more about the physiological treatment. E.g. depression with antidepressants. Less so the analyzation, Freudian, psychodynamic. Whether or not people will like my statement most psychiatrists I know don't know much about psychodynamics other than being able to say what an ego, ID, and superego are. For example how many psychiatrists have even read an entire book by Freud or Jung? The extent of psychodynamic training I see for most was the 1 lecture in residency and you were allowed to fall asleep during lecture if you were post-call.

Why some psychiatrists (and it's not many these days) try to portray themselves as some type of analytic Sherlock Holmesian level truth-detector when in forensic studies psychiatrists can tell no more if a person's bull$hitting or not over a layman is hubris on the part of those psychiatrists.

 

[docksan]

I was trying to think of a response to your post that was appropriate but I just can't.

The challenge of being a psychiatrist is not being a lie detector who can decode every human being's psyche, it's in being an analytical physician who can use their people skills to get as much information as they can from the patient and from collateral sources to form an objective opinion about what the most likely explanation is. When you see those patterns enough, you do get a feeling for how things are going to go down, much like any other field of medicine.

Anyone who went into psychiatry thinking they're able to know 100% the difference between truth and a lie is delusional, and that's not limited to American doctors.

 

[tr]

Psychiatry has become much more about the physiological treatment. E.g. depression with antidepressants. Less so the analyzation, Freudian, psychodynamic. Whether or not people will like my statement most psychiatrists I know don't know much about psychodynamics other than being able to say what an ego, ID, and superego are. For example how many psychiatrists have even read an entire book by Freud or Jung? The extent of psychodynamic training I see for most was the 1 lecture in residency and you were allowed to fall asleep during lecture if you were post-call.

I have read multiple original works by Freud and Jung. For the most part, I thought they were garbage. Freud seems to have analyzed himself (he was a mental health train wreck) and erroneously projected his insights onto the entire human population. Jung was just a weirdo but more of a fun read at least. The flying saucer stuff was endearing, but not what I would call clinically useful. I had two different psychodynamically oriented supervisors in residency and this just solidified my impression that it was, well, not for me.

 

[calvnandhobbs68]

I have read multiple original works by Freud and Jung. For the most part, I thought they were garbage. Freud seems to have analyzed himself (he was a mental health train wreck) and erroneously projected his insights onto the entire human population. Jung was just a weirdo but more of a fun read at least. The flying saucer stuff was endearing, but not what I would call clinically useful. I had two different psychodynamically oriented supervisors in residency and this just solidified my impression that it was, well, not for me.

Haha I too have read primary works by Freud (ex. Introductory Lectures on Psycho-Analysis) and have to agree with some of this. The readings are...interesting but no evidence base for any of it and basically draws lines between events/behaviors/emotions like you'd see on a conspiracy theory cork board, like doesn't seem to offer much concrete evidence for anything. Much more in common with philosophy, which is fine and interesting, but have to realize it's literally "just like your opinion man".

 

[Ludwig2000]

I’m gonna advocate for the devil real quick and make some counterpoints.

-Analyzing people and saying they have personality disorders is fun. It does make me feel above them and this appeals to my narcissism

-Putting people in boxes probably is intellectually limiting but so too is being such an empath or moral relativist that you end up not being able to make any judgments about anyone in your life. Take the middle path, Icari

-All science starts with philosophy. And all cogsci started with introspection. Freud was introspecting into his own weirdness, sure, but he was also trying to intuit what it was like to be a sensory being when your basic reality is tit vs no tit and then controlling your bowels etc. These things probably WERE primary stimuli that were being integrated into our brains/minds during its most plastic phases. The frame on which our machinery is built? Doesn’t seem crazy to me

-All of our current “empiric knowledge” is based on having given random drugs to patients and then trying to reverse engineer explanations for the stuff that kinda works

Anyways, hands down the best field in medicine, no sarcasm

 

[clausewitz2]

Psychiatry has become much more about the physiological treatment. E.g. depression with antidepressants. Less so the analysis Freudian, psychodynamic.

FTFY

 

[docksan]

Also, and I can't believe I missed that, psychiatry is 100% not becoming "all about physiological treatment". That's bunk. There is a large portion of treatment that is behavioral and all about the buy-in. Only the most sick of patients benefit from physiologic focus with medications. Not every patient needs medications.

 

[whopper]

I don't know if you were referring to me, but I didn't say "psychiatry is 100%", "all about physiological treatment." I said it's much more become that. Also in my same post I criticized that residency programs don't encourage more training in real psychotherapy stating that residents often times sleep through such lectures and professors don't care if they do.

I have a psychology degree and do consider myself a real psychotherapist, and not some MD who claims to know how to do it but doesn't. My wife is a doctoral level DBT therapist, authored several articles on it and is the head of counseling at a university and is quick to correct me on these matters. Most psychiatrists I know don't really understand psychotherapy other than supportive psychotherapy. Their level of DBT training is only to the degree of knowing it's the appropriate treatment for Borderline Personality and have no idea how to institute it themselves or the theories as to how DBT works. Also I've read several books by non-psychiatrists concerning psychotherapy such as Erik Erickson.

If anything I criticize that psychiatry has become in some ways too physiological. In several of my prior posts I've criticized psychiatrists that utilize medication all the time.

In fact I will throw this back. What does it say about someone who misquotes others and then exaggerates their claim? Let's analyze that person.

Let us begin.....(no seriously no. That'd be a waste of time).

 

[docksan]

Oh the hubrility!

 

[calvnandhobbs68]

I don't know if you were referring to me, but I didn't say "psychiatry is 100%", "all about physiological treatment." I said it's much more become that. Also in my same post I criticized that residency programs don't encourage more training in real psychotherapy stating that residents often times sleep through such lectures and professors don't care if they do.

I have a psychology degree and do consider myself a real psychotherapist, and not some MD who claims to know how to do it but doesn't. My wife is a doctoral level DBT therapist, authored several articles on it and is the head of counseling at a university and is quick to correct me on these matters. Most psychiatrists I know don't really understand psychotherapy other than supportive psychotherapy. Their level of DBT training is only to the degree of knowing it's the appropriate treatment for Borderline Personality and have no idea how to institute it themselves or the theories as to how DBT works. Also I've read several books by non-psychiatrists concerning psychotherapy such as Erik Erickson.

If anything I criticize that psychiatry has become in some ways too physiological. In several of my prior posts I've criticized psychiatrists that utilize medication all the time.

In fact I will throw this back. What does it say about someone who misquotes others and then exaggerates their claim? Let's analyze that person.

Let us begin.....(no seriously no. That'd be a waste of time).

Sure sure I agree with a lot of this but I don't know if the problem is that a lot of psychiatrists haven't read primary works by Freud or Jung. Basically, philosophy is fun to read but again there just isn't a lot of evidence/support for many of these theories outside of observation or practical outcome based evidence in general (compared to other less intense forms of therapy than 2-3x week psychoanalytic/dynamic therapy). I'm not quite sure Freud was better able to analyze any random person off the street (outside the context of basically becoming their friend with multiple time a week sessions) than anybody else and in fact there's evidence that he did a lot of damage with some of his "interpretations" at times.

I think for instance there's a lot more value in primary works by Aaron Beck/Judith Beck or Albert Ellis (although Ellis was a pretty hilarious guy in general) or Marsha Linehan (speaking of DBT) in terms of day to day practical use for most psychiatrists outside of wanting to do hardcore psychoanalysis/psychodynamic therapy which most of us aren't setting ourselves up to do.

 

[whopper]

Agree. It's not about reading the old classics as it is being on top of the real data of psychotherapy. Lots of psychiatrists don't know psychotherapy but because they are psychiatrists act as if they do and make some very inappropriate remarks to patients.

In St Louis there's this talk of "I'm psychoanalytically trained" and I've had situations where I tried to talk to these "psychoanalytically trained" psychiatrists who very little about psychoanalysis. The "I'm a psychoanalyst" is usually given out when such a psychiatrist doesn't know or care to know the more physiological aspects of psychiatry, and often times they don't know the psychotherapy stuff either. There are good psychiatrists that utilize psychoanalysis, but the above is usually used to deflect their own responsibility to lifelong learning.

 

[Mad Jack]

First off let me begin by saying that I’m a general resident in Australia who is aiming to start psychiatry training next year.

But one thing that always puts me off is the behaviour of psychiatrists and psychiatry registrars. They always try to “analyse” people and in a somewhat toxic manner. Im not talking about patients, but other collegues doctors, nurses and even at a dinner, the patrons.

I find it somewhat odd and they do it in a way as if they are putting the other person down?

It just worries me because if that’s the culture of the career I don’t want to end up like those kind of people.

Why do you focus so much on the analysis of others? Perhaps that says something about you fearing a magnifying glass turning itself upon you 🤔

Really though, I'm just kidding. I don't analyze people unless they are patients or they are so blatantly maladjusted that I can't help but do it internally, but even then I won't speak to others about it. Rare is the second case. Some traditionally trained psychoanalysts can give me the vibe you are describing though, however I find it to be rare in psychiatrists. If anything I find that being a psychiatrist has made me realize how not mentally ill most people are because I have a real yardstick for severe mental illness, whereas the average layperson seems to think themselves and everyone around them has something wrong with them

 

[whopper]

IMHO the basic tools that allow for analysis aren't taught well enough in psych residency to begin with and real analysis will require training outside of conventional residency programs these days. Such a training regimen IMHO should include a curriculum of psychoanalysis textbooks, reading up on developmental psych-not just child but adult and elderly, and abnormal psych.

 

[tr]

IMHO the basic tools that allow for analysis aren't taught well enough in psych residency to begin with and real analysis will require training outside of conventional residency programs these days. Such a training regimen IMHO should include a curriculum of psychoanalysis textbooks, reading up on developmental psych-not just child but adult and elderly, and abnormal psych.

And well they should not be. Any 'therapy' that requires the patient to be higher-functioning and economically better-off than 90% of the population just to be able to afford and engage in the therapy to begin with, is definitely not something we should be wasting residents' time with. A focus on high-yield interventions that are of use to the moderately to severely mentally ill is entirely appropriate.

Anyone who wants to learn how to charge high-functioning people $$$ to lie on a couch and free-associate for two hours per week for years on end (with summer vacations off, of course) is entirely welcome to do so outside the boundaries of taxpayer-subsidized psychiatric training.

 

[docksan]

And well they should not be. Any 'therapy' that requires the patient to be higher-functioning and economically better-off than 90% of the population just to be able to afford and engage in the therapy to begin with, is definitely not something we should be wasting residents' time with. A focus on high-yield interventions that are of use to the moderately to severely mentally ill is entirely appropriate.

Anyone who wants to learn how to charge high-functioning people $$$ to lie on a couch and free-associate for two hours per week for years on end (with summer vacations off, of course) is entirely welcome to do so outside the boundaries of taxpayer-subsidized psychiatric training.

All clinical training is subsidized by taxpayers, I don't see how that's relevant.

 

[whopper]

And well they should not be. Any 'therapy' that requires the patient to be higher-functioning and economically better-off than 90% of the population just to be able to afford and engage in the therapy to begin with, is definitely not something we should be wasting residents' time with. A focus on high-yield interventions that are of use to the moderately to severely mentally ill is entirely appropriate.

Anyone who wants to learn how to charge high-functioning people $$$ to lie on a couch and free-associate for two hours per week for years on end (with summer vacations off, of course) is entirely welcome to do so outside the boundaries of taxpayer-subsidized psychiatric training.

I don't disagree with your statement but it does imply a very specific view on what psychiatry is or at least what residents should focus upon. To that end (assuming I'm not misinterpreting you) psychiatry isn't about the older approach our field used to do as the norm. That is the old-fashioned couch-therapy.

Which is in-line with what I said before. For better or worse (And I'm not saying it's better or worse, just saying what it is), these days psychiatry is not so much analysis as it is physiological approaches to treatment. I wasn't surprised to see someone think I meant this in a x vs y mindset which I didn't. I was simply stating what is going on.

I do criticize a lot of the older approaches of psychiatry. E.g. much of what was done prior to the 80s has very little evidence as a foundation. Psychoanalysis doesn't work for every aspect of mental health treatment and yet despite this it was utilized in so many inappropriate areas such as treatment of psychosis. (Again someone will use the above sentence to attack me. I am saying what was going on and not saying psychoanalysis is always inappropriate. "You wrote that you're against psychanalysis" despite that this is not what I wrote. It's very appropriate for some situations, not all).

 

[SeniorWrangler]

I think Carl Jung’s work is pretty great. It is not evidence based and shouldn’t be subsidised or purchasable with food stamps but it’s very stimulating intellectually. There is more to life and therapy than RCTs and manuals.

 

[tr]

I don't disagree with your statement but it does imply a very specific view on what psychiatry is or at least what residents should focus upon. To that end (assuming I'm not misinterpreting you) psychiatry isn't about the older approach our field used to do as the norm. That is the old-fashioned couch-therapy.

Which is in-line with what I said before. For better or worse (And I'm not saying it's better or worse, just saying what it is), these days psychiatry is not so much analysis as it is physiological approaches to treatment. I wasn't surprised to see someone think I meant this in a x vs y mindset which I didn't. I was simply stating what is going on.

Are you conflating psychoanalysis with all types of psychotherapy? Modern psychiatry includes both a large toolbox of biomedical interventions *and* many highly effective, evidence-based psychotherapeutic and behavioral treatments. I disagree that psychoanalysis fits in the latter category.

I do criticize a lot of the older approaches of psychiatry. E.g. much of what was done prior to the 80s has very little evidence as a foundation. Psychoanalysis doesn't work for every any aspect of mental health treatment

FTFY

 

[calvnandhobbs68]

Looks like we got ourselves a real psychotherapy throwdown here....look what you started OP.

 

[whopper]

Are you conflating psychoanalysis with all types of psychotherapy?

No I was already aware, and mindful of this when I wrote the above comment. Psychoanalysis is a very specific type of approach and doesn't represent all psychotherapy. Psychoanalysis, however, was utilized much more decades ago than it is today.

Psychoanalysis doesn't work for every any aspect of mental health treatment

I didn't change that comment-you did. I meant my original comment. So I don't know if the comment you changed is your opinion.

 

[Ludwig2000]

Looks like we got ourselves a real psychotherapy throwdown here....look what you started OP.

Don't bring an SSRI to a Jung fight