To ask why psychiatrists are viewed in this way

[busyweeks78]

I’ve only ever had positive experiences with them but as a general rule the stereotype seems to be a negative one. Aibu to ask why?

Re: psychoanalysis. A Freudian approach to mental distress that is pretty outdated. More effective therapies are available which is why it’s not used. Psychoanalysis is the straight white mans approach to mental health.

I can only talk about myself. My psychiatrist literally saved my life when I was in my 20s and had profound depression and tried to kill myself twice. I have had a few bouts of depression since but that first experience of getting better showed me that it's an illness and I can get better. Shows me that there nothing inherently "wrong" with me. I just have this condition like some people have ME or endometriosis. I suffer of depression. No value judgement. I respond well to medication and feel very sorry (in a true, empathic,heartfelt way) to those who don't.

I’m one ( not sure if I should be admitting that) but my thoughts are - people do get over diagnosed and over medicated in many cases and a holistic view isn’t always taken. Diagnosis should ideally be something that is helpful to a person giving a treatment plan and an explanation for how they feel. Antidepressants can be literally life saving and mood stabilisers can keep people with bipolar disorder in work and maintain family and personal relationships. We detain much less nowadays - partly due to pressure on beds and partly due to recognising that people are best looked after at home if at all possible. Early intervention/ crisis and liaison teams can be amazing in this regard. However people do need detaining sometimes and again it can be lifesaving in an acutely suicidal person. Talking therapies can make a massive difference to people’s lives and wellbeing. We are desperately underfunded in MH services and this does have a massively negative impact on people’s experiences. Long waiting lists to see us and talking therapies can lead to an over reliance on medication. Poor social care also has an impact. In terms of my colleagues we are a mixed bunch as all professionals are but it’s worth remembering that people see us when at rock bottom and sometimes their mental illness can make them openly hostile and suspicious of us and they can lack insight that they are actually ill at all. I feel I do my job well and put the patient at the centre of what I do, try to make collaborative decisions, don’t over medicalise, remove diagnoses and medication where I can. I work in the community and for context I only detained patients four times in 2019 and had hundreds of patient contacts

My psychiatrist was a lovely, lovely man and basically saved my life (just balancing some of the negative posts)...

@tectonicplates I'm still not understanding the difference between psychotherapy and counselling.

You're not alone there! There is a massive overlap. Massive. The bottom line is that anybody can call themselves either of those titles - you don't actually need any training to call yourself a counsellor or psychotherapist. If you go to see one it's best to make sure they're registered with the BACP because that has a baseline for membership. That means too that IF they were unprofessional that you could report them to the BACP. Their registration number should be somewhere on their website.

Generally speaking though people who do short counselling courses are unlikely to call themselves psychotherapists. Not impossibly, but more likely they'd call themselves counsellors. People who call themselves counsellors though may have very extensive training and use that word because it's less scary sounding that "psycho-anything".

Look for registration and never be afraid to ask where they studied if going to se one. They can both be very good and have in-depth knowledge of sub clinical mental health issues (not at the level of a diagnosis) and tools for helping navigate through them.

Paychitrists are often very scathing and nasty about people with personality disorders (but are nice to their face, just horrible about them.in team meetings).

Are you willing to state how you know this?

Just remembered I voluntarily saw one (abroad) in my 20s. He was highly trained and very well-known where I was. I talked about being raped. He was very interested in whether I'd been a virgin at the time or not (I'd been 18). It was a 10 minute appointment. Caused me more damage than not going would have. Always had a slight niggle since then that it wasn't really that bad because I'd not been a virgin. Even though I know that's irrelevant (at least in some ways).

I was under one psychiatrist on and off for probably 5 years. I kept getting discharged and then bouncing back again - one might have thought I missed them.
He was nice, but didn't tolerate me declaring myself to be anything other than ordinary.
I've had a few others (mental health services seem to rotate staff or otherwise have a staff retention problem!).
Then I had this lovely guy. He actually broke the mould in terms of how he helped me. He was lovely.
My current dude is fine though I have only met him twice and he's really chatty when he gets the formalities out of the way.

My first psychiatrist (the dude I had for about 5 years) is now the Head Buck Cat in Ireland - this is the fella who wouldn't pander to me self-diagnosing lol.

I had to deal with them for over 25 years when we had someone we wanted a consult/admission into a unit. Never met one who was not weird as fuck.

Anyone I've known who has become a counsellor had ishoos of their own -I'm not sure if this is a good thing or a bad thing.

Wow. Mixed bag of opinions here!

I think a lot of you are mixing up psychiatrists and psychologists for a start, and they're very different.

Psychiatrists work in one of the most poorly funded yet in demand services in the entire NHS. It's not really surprising we're failing, but it's not really down to psychiatrists as individuals.

There'll be good ones and bad ones. At the end of the day they're just people and people come in good sorts and bad sorts so not really anything to be surprised about.

Yes, some are a bit odd. You have to remember that to be attracted to psychiatry as a career, you tend to be fairly empathetic and sensitive as an individual. And then you spend your entire career listening to the absolute worst of what humanity is capable of doing to each other. Every day. And you're expected to fix it with the above mentioned lack of resources. It's bound to send you a bit odd after a while. Either that or you become quite detached from it all as a coping mechanism, which leads to some of the other complaints people have about psychiatrists not really caring.

I'm a psychiatrist. It's not easy, believe me. I promise you, the vast majority of us are doing our absolute best for you

Because of a close family member's MH issues, I have had a LOT of experience with psychiatrists over the years. Every single one of them has been odd – some overtly batshit, some slowly revealing their weirdness, most somewhere in between. No longer dealing with family member's MH care so have not had dealings with a psychiatrist in years.

Fast forward to earlier this month when I had to work with a psychiatrist intimately one for an entire day as part of my job. All seemed completely normal, when bam! in the last meeting of the day psychiatrist came out with something so surprisingly horrible and mean that it made everyone gasp and then some laughed uncomfortably.

I stand by my prejudice.

And then you spend your entire career listening to the absolute worst of what humanity is capable of doing to each other

Maybe in a prison? I don't believe that otherwise - lots of mentally ill people are perfectly capable of kind behaviour

I'm hoping justdecking means worst of humanity as in people causing others pain and the like, rather than mentally ill people being awful humans? Surely?

I think it IS clear that justdecking means the stories patients tell her of the traumas they have suffered and had done to them, more than the reverse.

Well you'd hope so but it sounds more like a suggestion that all the patients s/he sees are telling tales of their terrible behaviour

Psychoanalysis (and psychodynamic psychotherapy, the more commonly encountered, once-a-week version of this modality) is actually having a bit of a resurgence. It's suffered from a self-inflicted lack of data on efficacy - but new evidence actually suggests that it's more effective, and more long-lasting, than most other approaches to many common problems (depression, anxiety etc). It's the only modality which focuses on early life experience and tries to effect permanent change in how we think and experience, rather than addressing the symptoms and/or effects. It's a LOT more expensive than medication or CBT though.

I have had three psychiatrists. Two were great and one was awful. I think the awful one exactly crystalised the reasons why some people are so wary of psychiatrists. She didn’t listen. She only saw me about three times yet she’d decided things about me that no other professional had observed. She had her own fixed ideas and preferred treatments which she’d push onto her patients. She put me on her favourite medication, it had awful consequences so I came off, then next time I saw her she was trying to get me on it again.

the problem with psychiatry is it’s not really a science, it’s more of a case of throwing as much at a problem as you can and hoping something will stick.It’s 50% prejudice and preconception, 40% trial and error and 10% knowledge imo. It’s hardly an easy job to do well though and it relies on a psychiatrist getting to know a patient, and that just doesn’t happen in the NHS. There are some terrible ones though, there’s no doubting that.

That's what I assumed. People must reel off so many awful traumas they've experienced and psychiatrists are only human.

And then you spend your entire career listening to the absolute worst of what humanity is capable of doing to each other
*
Maybe in a prison? I don't believe that otherwise - lots of mentally ill people are perfectly capable of kind behaviour**

I don't mean the patients, I mean the stories they tell us about what's happened to them

I think its largely because people dont understand the different job roles within mental health.
A psychiatrists job is a medical doctor who specialised in mental health conditions and disorder. They use a medical model and look at diagnosis and medication.
A psychologist looks at mental health in a holistic manner and uses therapy as a method of managing mental health but is not a diagnosis or prescribing professional (they lack the qualification and powers to do so as it's different training and are not medical doctors).
So if you go to a psychiatrist and expect them to do a psychologists job then yes your going to be disappointed.
The main reason psychiatrists and medication is over used is that there aren't enough psychologists/therapists/counsellors to go around unless you go private and VERY long waiting lists if you do get put on one as therapy is a long process.

Also often without appropriate medication people with mental health issues will struggle to respond appropriately to any form of therapy. In a ideal world psychiatry and psychology would be used intertwined to compliment each other.
Likewise many psychiatrists are at breaking point due to mental health services being at breaking point and dont physically have the time and resources to do their jobs as they would like to, eg having the time to spend with a patient to look at everything rather then being expected to make quick judgments on limited information. This is not the fault of the psychiatrists but rather the medical system they have to work under and the pressure that is applied due to a NHS which due to no fault of it's own is unable to hope with demand due to cuts and lack of funding but also due to many professionals retiring and leaving the uk health service but not many young british people training in the professions (to he psychiatrist you have to complete a medical degree 5 years + usually have experience as a GP then specialise as a psychiatrist so it takes a VERY long time and ALOT of hard work to work in a system which causes a lot of stress and working ridiculously long hours, usually standard practice hours + on call hours + in multiple other services)

I thought psychiatrists did another 2 years after their 7 years of medical training.

I think the minimum amount of time is this: medical degree (5 or 6 years) + 2 years as a Foundation doctor + 6 years of specialist training (equivalent to the old system of 3 years as a Senior House Officer and 3 years as a Specialist Registrar), including qualifying for membership of the Royal College of Psychiatrists (professional exams, written and clinical) > Consultant Psychiatrist

@Keepyoursockson, you've misread my post.

I think it's unfair to say that psychologists work more holistically than psychiatrists - I've met plenty that don't...

Psychiatrists tend to be men and by definition there’s a massive power imbalance

This isn't true - there are more female doctors specialising in psychiatry than male as of last year.