To think most psychiatrists lack empathy

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Especially with regard to sucidal patients. I know of a young woman recently who was told me a psychiatrist that it was her choice if she took her own life.

Absolutely. I’ve seen several over the years and I often wonder why many do the job when they seem to lack so much empathy.
They also make sweeping decisions completely opposite to the one before so you get no consistency.
Same with MH workers though. So many nurses and support staff in the psychiatric wards who make it clear that they have no interest in the patients.

I don’t ses what’s wrong with that the psychiatrist said. It’s true, it is ultimately your friends choice whether they take their own life or not.

Absolutely. It is her choice. And a psychiatrist who takes every distressed patient they treat terribly to heart, and is begging them not to choose suicide, isn’t going to be effective one.

I think they can come across as being somewhat detached or cold.

I remember one time when I was at the lowest of the low and went in to ask for help and I was told to pull myself together and get some self esteem. I wasn’t suicidal- thank god - but I can’t imagine if that had been said to someone who was.

edited to say: I am a bit shocked to read people’s responses about saying that’s her choice. Of course it’s her choice - that’s not the issue. The issue is seeing beyond the trees to a possible better outcome. Whilst begging someone not to do it might not be an efficient manner - telling them it’s their choice might actually be seen as encouraging for some patients as suicidal patients often feel there is little they can control - and this could give them the idea that is something they can control

Not in my experience, my psychiatrist is extremely empathetic. The point about suicide being a choice is an interesting one as I’ve actually had a few debates on the subject with him (I have a Masters in Medical Law and strong views on the topic of consent and capacity). Ultimately, I don’t think it’s wrong to say that people have agency over their own lives though.

No

When I was in rehab for alcohol all the counsellors were in recovery , as were the office staff

But that was 30 years ago and Im sure if I tried to access services now, it would be a lot different

A friend of mine does psychiatry- he said in college when they went around the class most people went into it because they had issues/ needed a lot of therapy and so/ as a result of were intrigued by it. After he said it he didn’t get why I was so shocked

Compassion fatigue is real ….
it’s an incredibly draining job I’d imagine.

To be honest I’ve never met a normal clinical psychologist

Maybe I’m unlucky but the eight I know including family members are especially manipulative and insincere people.

I can guarantee you that your friend isn’t a psychiatrist. It’s a medical specialism. You go to medical school, train as a doctor and specialise in psychiatry rather than, say, paediatrics, cardio or anaesthesiology. You don’t go to college and sit around in a circle chatting about needing therapy being why you chose to become a psychiatrist. Psychiatry has nothing to do with therapy. Psychiatrists do five years of medical school before starting to specialise.

My dds psych is amazing.
He is very empathetic but we do see him privately so maybe that helps.

I can't imagine him being different through the nhs. Maybe less time with each patient is the main issue.

CrosswordBlues

From the way he said it I don’t think it was in class, they were all out somewhere together. He was about ten years in college in Trinity college Dublin, definitely did psychiatry

We had a clinical psychologist in our team, she’s just left, she’s extremely skilled and knowledgeable. Likely also has some issues, most people do.

I thought dh’s psychiatrists were special people tbh, very different but able to spend time with so many very unwell people without apparently going off the rails themselves. They all appreciated the many wonderful things about Dh but also kept some detachment. He did take his own life and ultimately, yes it is a kind of choice. At the time it clearly seemed to him to be the solution.

With my limited interactions I'd say that they are just doctors. A lot of doctors lack empathy. While orthos treat knees, psychiatrists treat mental disorders. They're not therapists. They take info's and make a diagnosis and treatment plan. Equally terrible bedside manner as all doctors. Some are good, some are bad.

I read this article where people told stories about what helsth care workers said to them at the a&e after suicide attempts. Terrible to read.

Burnout. Really really high levels. Huge expectations, bed pressures, SUIs

Depends what sort of context and tone it was said in really. I'd not find it particularly lacking in empathy. I wouldn't want to be treated like a poor hapless victim. And if they trotted out "suicide is a permanent solution to a temporary problem" or any of the like I'd be straight out the door!

It is her choice though, isn’t it.
I don’t mean that in a crass way but sometimes people want others to make the decision, asbolve themselves of responsibility, or to test them. I suspect the psychiatrist was aware she was doing something along those lines so put it back to her to see how she would respond.
I would expect/hope that if she was assessed as being genuinely suicidal then she would have been sectioned.

I have been told by psychiatrists and other MH professionals that suicide is my choice... and they are right.
it might sound harsh at the time when I am in the thick of crisis, but it is true. I can choose to give in and give up, or take up their offer of help and try to fight. My choice. The latter is very hard though.

Saying that, the reason for thoughts of suicide can be different. If you are psychotic and voices/delusions are telling you that if you die then your family wont burn in hell etc, is vastly different to someone feeling that there is no hope and suicide is the only option.... if that makes sense.

Some people do tell the MH service that they will kill themselves if they don't help. That is emotional blackmail.

The most effective MH professionals involved in my care used a little bit of tough love.

My friend said that she believes it was this exact detachment from a psychiatric doctor at in-patient hospital that saved her suicidal daughter’s life. He said something like, “well, you haven’t killed yourself, have you? Are you really going to do that or is it time to grow up and work on these issues?” She was an older teen (18/19) and this woke her up and, frankly, made her question if her behavior was immature. 10 years on and no longer suicidal, her mom still is grateful for his approach.

caveat: I have no idea if this works for everyone and psychiatrists aren’t gods. They can make mistakes as much as the rest of us.

I'm a mental health nurse. You do get some people who appear to lack empathy. I find this is the case particularly on wards, and personally feel the power imbalance between staff and patients go to some people's heads.

Outside of that though, most mental health workers are compassionate. Sometimes people word things clumsily or etc, but I truly believe most are just trying their best under burnout in a very strained/high pressure system.

Also psychiatry is very different to psychology. Psychiatry is built around the medical model. Psychiatrists will be trained very differently to other mental health professionals. The role of a psychiatrist is ultimately to oversee medication. The role of a psychologist is to unpick what is going on and what causes your issues. Their training is wildly different. Mental health nursing imo is a mixed bag of everything.

Was going to say the same as this. I’m a therapist and work in a university but work closely with NHS staff. Some of them seriously lack compassion but it’s easy to burnout when you’re seeing so many people. Also it must be frustrating when there’s such long wait list and some people aren’t engaging then get pissed off when they’re taken off a wait list.

psychiatrists do approach patients using the medical model so maybe the whole, youre chemical imbalance needs to be fixed with medication can dehumanise patients?

also there are lots of narcissistic people working in mental health as there is a power imbalance there and people can get a god complex

Not a psychiatrist, but I have had occasional patients tell me that they will kill themselves if I don’t immediately do x, y or z (give them opioids, get them a transplant when they aren’t suitable, get them magically rehoused).

Funnily enough none of them ever have followed through.

I'm really interested what a more empathetic approach would have been? Should the psychiatrist have got upset? Begged the patient to stay alive? Would that really have been helpful to them?

My experience is that professionals care very much, but know that a calm discussion is generally the most helpful. It helps to co-regulate a distressed patient.

I don't think there is anything wrong with saying that.

This was my psychiatrist www.dailymail.co.uk/news/article-13782355/Richard-Seamark-lismore-mental-health-director.html