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?

Sadly psychiatry is ime very limited. There isn't a pill you can take to cure you of thinking that people are going to kill you. There isn't a pill you can take that tells you you aren't irredeemably bad. All they do is give you pills that sedate you so you give less of a shit and cause less trouble.

That's not my experience at all. Pre diagnosis and treatment I spent a lot of my life experiencing a bunch of weird thoughts and feelings. I would have manic highs where I believed that I had been sent by the gods to control destiny by having sex with people the gods sent to me (it makes no sense). I had horrible dark periods where I thought the signs on the tube were telling me to jump in front of a train. I thought people were following me.

Medication changed this. I am not cured exactly - I get episodes, normally in response to big changes, but they are much shallower than they used to be - I might be depressed and struggle for a couple of months instead of be unable to leave my room for months, or, I might get a bit hyper and have some odd ideas about writing a novel but won't get actively delusional or destructive. I've had 18 month stretches of no symptoms, which never happened before.

I sometimes still get intrusive thoughts and messages, but I've managed to keep the insight to ignore them, and the work I've done with my CPN has really helped keep them all under control.

That isn't a cure, exactly, but it means I can hold down a job, have a family, friendships, a life. And yeah, it's still a lifelong chronic condition, like diabetes, but that doesn't mean you'd say "insulin is worthless - it doesn't cure you, you could get sick again any time you stop taking the pills".

Sorry about this long post but I feel have to say a few things from the inside, as it were.

I am a consultant forensic psychiatrist, and have been for over twenty years. This is a really depressing thread, I must say. There are good doctors, OK doctors and bad doctors in every speciality, and the overwhelming negatively about psychiatrists on here is really sad for me to read. There are lots of reasons for this of course, some are to do with fear, misunderstanding, cultural factors etc. One reason is because most people, when they see a psychiatrist, are of course mentally in a very bad place, and that will colour your whole view of the world. In my field all my patients are detained, so that does also alter the dynamic as you are in effect a jailer as well as a doctor. This has to be taken into account in therapeutic relationships, and is not something we ignore.

I am not going to defend all psychiatrists, we are not a homogenous group, even in my subspecialty, but would say that there are a lot of misconceptions on this thread, borne no doubt of unfortunate and regrettable anecdotal evidence, as well as general lack of psychoeducation in society as a whole. I feel terribly sorry for all the people who have had negative experiences of the mental health system and of specific professionals within it. I so wish you had had better care, as you would have deserved. However, there are many many people who could also point to negative experiences with specialists in other fields, whether through incompetence or uncaringness etc. I do a significant amount of work in the field of medical negligence and it is an eye-opener dealing with cases where people have suffered so much because of poor or incompetent care in diverse fields, whether that is because of a system not working or individual professionals being negligent. I have seen this in obstetrics (often with tragic outcomes), surgery (with life-changing or fatal consequences), and numerous other fields. I have also seen it in psychiatry, of course.

Just to mention a couple of specific points raised in the thread above. Psychiatrists are most definitely not generally uncaring or unkind. They are not (in the UK at least) mostly male. They do not use only pharmacological treatments. They are not "snake oil salesmen" but use medication, of course, as most types of doctors do, sometimes successfully, sometimes not so much. Would you call an oncologist a "snake oil salesman" because some of their patients did not recover after chemotherapy?

Psychiatrists have trained for many years (in my case over 20) before becoming a consultant, and often have other qualifications alongside their medical qualifications, as I do. They are often treating conditions which are life-long and incurable, albeit hopefully amenable to improvement through treatment. This means that, like a great many other types of doctors, they are not going to be able to make some people completely “better”, no matter how good they are. General and CAMHS psychiatrists (not so much forensic as we are far better resourced) are currently totally overwhelmed by pressure of work and lack or resources and personnel. Many are burning out precisely because they do care but are unable to make enough of a different to patients’ lives because of the lack of people and money in the mental health system.

I will of course be biased but I want to say that we are emphatically not “failed doctors”, and this sort of nonsense is particularly upsetting to read. I never wanted to be any other form of doctor from the very beginning (long before university), and this is a very difficult job. I do not consider it in any way easier than any other form of medicine. I would not be able to be a surgeon, as I hate theatre, or a paediatrician, as this would make me too upset, etc etc for other specialities, but that does not mean I have “failed”. It means that like millions of other lucky people in the world I chose a profession that I am happy with.

TheDudesMummy

That was a touching and thoughtful post.

@thedudesmummy

Well said. I work in the field too and have noticed that psychiatrists and social workers have far more "difficult" relationships with patients because they were often the ones who had sectioned them. They were seen by patients as "authoritative figures". I used to run inpatient therapeutic groups within the hospital so their reaction to me was often much more positive because I was offering them fun activities and also allowing them to explore their feelings in a more relaxed environment.
There wasnt the pressure to 'prove themselves well" as there can be in ward round meetings.

I have seen three psychiatrist all amazing individuals. My first treated me with the upmost care and kindness, prescribed drugs I needed and Helped rehabilitate me back into the community after a long stay as an inpatient. Second sat with me for over an hour and tweaked my drugs slightly visited me at home to hand me over to the community team. Third listens to me occasionally says things I disagree with but listens to my opinion, believes my drugs are maximised and holds talking therapy in high esteem. I currently get 2 hours DBT a week, one hour one to one with my therapist, an hour with my care coordinator and a monthly appointment with psychology. In a year I will be undertaking trauma therapy. This is all NHS and I am massively grateful

Dudes mummy thanks for your post - I am also really sad to see such negative views of my profession

I have bipolar affective disorder and an amazing psychiatrist who saved my life.
Further up the thread someone referred to medicalising feelings. You don’t get referred to a psychiatrist because of some bad feelings. My psychiatrist has worked carefully with me to find the right balance of medication, she’s not trying to zombify me.

I worked with a wonderful but utterly shambolic psychiatrist ..hair all over the place , notes falling out of files, food on his tie...we were in a client meeting once and the elderly female patient got up and spit washed him with her hanky, telling him off for not looking after himself properly . The best one was in a meeting with very polished , highly professional senior managers and clinicians, all pin sharp and hyper managerial, he reached into his jacket pocket and brought out half a pork pie and started munching on it , spraying bits as he spoke ...the look on their faces!😬😂
He was also the most caring and humane man and developed very effective interventions that saved lives .

DD has required the services of child psychiatrists for several years. We’re grateful to have had the opportunity, as they are so thin on the ground and the demand for their services is high. They were mostly pleasant and helpful, though one was a bit useless and not too child friendly. Recently we’ve been seeing a new one. She is fantastic and it has given me confidence about DDs future treatment and prospects.

I had no idea psychiatrists were so reviled. I’m so grateful to have had their expertise and help.

Love that @ginandbearit but I fear those types are few and far between.

Thanks for the positive posts! The way psychiatrists are portrayed in fiction, especially movies, is also a problem, I believe. I cannot stand watching any movie that has a psychiatrist in it, they are either completely scatty/frankly mentally ill themselves or power-mad Nazis. I have never met either type in real life...

@slipperyeel totally with you on this. I have multiple disorders and complex mental health and had ZERO quality of life until I was put under my psychiatrist. I actually have a life, albeit not free from difficulty but can actually see a future for myself now. Yes medication can bet a bad rep as not every one works for different people and can have bad side affects/people dont give medication long enough to settle/ and unfortunately diagnosing mental health conditions and disorders can sometimes require method of deduction, and just like doctors/nurses/carers theres bound to be a few rotten eggs. But I have upmost respect for people who chose to stay in this profession when they are so clearly being worked into the ground and put under huge amounts of pressure (my psychiatrist is the lead in adult and children's mental health plus autism service plus crisis/access team, is the main duty on call for out of hours,and also helps out In voluntary counselling services), and has aged 10 years in the past three, but has feeling the pressure of having none else to do the work as out of the two me mental health centres in my county ONLYONE actually has access to psychiatrists due to retirements, people moving out the area or going into private practice.
Some people may think medication is unnecessary and honestly I'm jealous of those individuals as I would not be alive or have any quality of ,life without medication and have been on 8+ tablets a day since my early twenties, but this is what it takes to actually have a life and therefore a happy marriage and follow my chosen career so I'm gracious for it.

The purpose of a psychiatrist to too consider ailments of the mind in a medical model and to deal with complex mental health which requires medication at least as a interim/starting point. Otherwise your better seeking referral to therapy which is like gold dust and often better off going private or using a charity based counselling service such as mind.

@LittleDragonGirl - so glad you’re functioning, only when you’ve been really unwell do you realise how amazing that is!

People definitely confuse psychiatrist and psychologist.

If you want to talk about your problems, psychologist.

If you want medicine for your problems, psychiatrist.

Often times you need both.

And to add to that, people should certainly be grateful for the existence of both... They are a much-needed contribution to our greatly lacking mental healthcare services.

Thedudesmummy - your post was lovely to read. I also have worked in forensic mental health for many years, but sadly my psychiatry colleagues were not as nice as you. The way the clients were dehumanised by all of them was awful :( I was deeply saddened by the lack of care for some of the men I worked with, and the lack of attention paid to their horrendous and traumatic pasts. Current symptoms often out down to "well they are just typical of", rather than considering the role of trauma. I wish I had been able to work with you. But in my experience, kind psychiatrists like you are a rarity.

(And of all the psychiatrists I've worked with, very very few have been female, especially in the prison service.)

Sorry .. 'current symptoms often out down to "well they are just typical pd" .....'

Grrrrrr the typos! ... 'often put down to ....'

NeedToGoToBedNow, That is really rather sad. I hope it is not indicative of forensic services in general, it certainly is not in ours. We are more than half female in the consultant body in our service by the way, and more than half of those consultants going into the prisons are female. Maybe that has something to do with it, although it shouldn't of course. I have chosen to stay in the same service for nearly thirty years (precisely because it is not full of the types of people you describe).

I would strongly disagree with the sentiment that you just need a psychiatrist for prescribing medication. Many psychiatrists are trained in various forms of psychotherapy as well, we all have to do some supervised psychotherapy while training, and although not everyone engages in this further after that, many do. Also, the role of the psychiatrist is not just to prescribe and to treat patients, it is much more that that, including diagnosis, risk assessment, liaison, team leadership, management, teaching, research, medico-legal opinion.... (not every psychiatrist does all of these obviously, but these are all roles that psychiatrists carry out).

It’s lovely to see responses from psychiatrists.