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.

They have to be.

Becoming emotionally involved in mentally ill patients is not going to make them good at their job.

Idk exactly what situation your friend was in but it is true that it's her own choice to take her own life or not. If, as can be the case with some PDs and mental illnesses, she had started to weaponise suicide, ("If you don't give me XYZ I will kill myself and it will be your fault,") then she definitely needed to be reminded of that.

The ones I work with all have empathy but some are more direct than others. The same with other MH professionals. Some of the abuse they get from a small minority of patients and family though is horrendous.
At times they may be more 'boundaried' with patients as part of an approach. There is usually good reasoning for that.

Well at least they don't have to touch patients, I thought that's why they did it

I met some lovely psychiatrists when I needed appointments for my daughter. I was paying though.

Ive met many doctors that are autistic though and can come across as ‘cold’. The psychiatrists weren’t.

I am so sorry that this was done to you.
What a horrible situation that I will not stop thinking about xxx

I don't really expect psychiatrists to be that empathetic I do however expect psychologists, the crisis teams, cpn, counsellors to be and their often not. And it really pisses me of when you call the crisis team suicidal and they say you have capacity so they can't do anything to help you so if you want to kill yourself thats your decision.

Psychiatrists vary a lot , some are incredibly empathetic, others can come across as blunt or clinical.

… I mean it is someone’s choice if they take their own life. That’s a statement of fact… they make a choice to do that. So what do you want the psychiatrist to say?

When I was undergoing counselling supporting my DH who was suicidal, the counsellor said suicide is an act of anger, either against the world around them or against a person. I’ve thought about this a lot. I agree that it is a choice too. Sadly I lost my DH to suicide- there was absolutely nothing I could have done to stop it. He’d made up his mind. Faced with that, I think his psychiatrist anticipated what was about to happen and was quite detached, to protect their own mental health I would imagine. It must be a hugely draining job.

Exactly, and it would have been said in reply to something this woman said, it wouldn’t have just been this one comment without context. Psychiatrists should talk about suicide in a very open way. They can’t judge, so if someone says it’s their choice if they kill themselves, a psychiatrist is right to say that it is. The patient has the right to live how they want to, within the law, or to choose not to live. By acknowledging the woman’s feelings and her right to choose, it creates a feeling of a safer space for her to discuss the reasons for her feeling this way. That is being empathetic in their role as a health professional.

They are not friends who love the person they’re talking to, so empathy looks different.

Mine I guess could appear to be cold. But I needed someone grounded in reality to help me sort through some stuff. She’s not my friend or my husband who are supposed to be sympathetic and “on my side”. The point is your perspective is skewed and an effective psychiatrist will help you unpick what actually “is” not your disordered perspective.

I agree that suicide is a choice if you deconstruct it to its basest elements. Much like an alcoholic makes the decision to consume alcohol and then get in the car and drive.That person has made the decision to end their life by whatever means.
However, if that person is so gripped in mental crisis, that their capacity for rational thought has deserted them, then its hard to see that it is a choice?
Just like mental capacity can desert you after a physical event/illness, like Stroke or dementia.
There are some good examples, though, above, of where a threat of suicide can and is, sometimes, used in a manipulative way..."I'm going to kill myself and it'll be your fault"

I know someone who is a psychiatrist. He specialises in the very highest realm of criminal psychiatry in "secure hospitals" and deals with some of the most heinous crimes one could imagine.
He is flippant and frankly cruel, and comes across as proud of it, but i suspect this is used to hide a whole host of issues he has, himself.

Hallelujah!

Absolutely. Thank you for making this clear.

i think people are confusing psychiatrists with psychotherapists and counsellors. Psychiatry, as you say, is a clinical specialism and analytic and diagnostic rather than always therapeutic.

Why was this problematic?

Is it not her choice? Was it that she wanted someone else to take the blame for it? was it that she wanted the psychiatrist to stay with her all the time until she was better?

I don’t mean this unsympathetically to her - but what was she expecting to hear as “support”?

They are there to do their job not be a friend 'there there everything is fine yes the whole world is against you' they are not there to tell a patient what the patient wants to hear

When you’re talking to a psychiatrist, they’re usually completing very detailed assessments to arrive at a diagnosis - their questions are designed to check whether you’re meeting stringent diagnostic criteria, so that the diagnosis is accurate. In the limited time they have with a patient I imagine that providing high levels of empathy etc too is quite difficult and it’s not their aim. They would refer you on to therapy / counselling for you to access that type of caring, supportive discussion.

Self-preservation...it's a tough job with very challenging patients who can rarely be "cured" even after years of treatment.

I work in secondary mental health services (don’t want to name profession as it would be outing) but 99% of us really do care. It’s a horrifically gruelling job and mental illness is really, really complex. We can’t save people, we’re there to empower people to keep themselves safe and to build an identity alongside their illness. I think people ‘on the outside’ expect us to save people and if we’re not doing that then we’re considered to not give a shit. There will always be staff in any profession who don’t care or don’t do the job well. We also suffer compassion fatigue which doesn’t help - it’s hard to imagine what we deal with every day but it’s difficult to remain compassionate day in, day out.

Also to add, not sure what diagnosis or presentation the person in this story had but especially with complex emotional needs, emotional intensity and personality disorders, professionals really have to be boundaried and place the responsibility for patient safety on the patient themselves. This out of context quote that OP has shared isn’t necessarily awful because ultimately it is true! Person may have said ‘it’s your fault if I take my own life’ (we get this all the time)….

I’m very sorry that your husband completed suicide. I’m glad you know there was nothing you could do. I hope you’re slowly healing x

I should imagine a certain professional detachment is a good thing. It may come across as cold to you but imagine how many suicidal patients they come across every week (day?). You would need to protect yourself.

I'm a HCP and find that a lot of people have unrealistic expectations of how much empathy and lasting interest a HCP can have about each and every patient in a long line of patients that they are briefly involved with and do not actually know in any meaningful way.

We also have our own lives, families, problems and illnesses that require our compassion and empathy, and we can't just stop coming to work every time something comes up in our lives that requires this energy.

If they are unprofessional, intentionally unkind, breech best practice guidelines or breech a patients right to autonomy in the presence of capacity that is a problem. Expecting limitless empathy from someone across a 40+ year career featuring 1000s of patients is unreasonable and bordering on entitled.

I doubt it would be outing, there are lots of people in each profession in secondary mental health care. The role of a psychiatrist is very different from a clinical psychologist or mental health nurse. A psychiatrist is a doctor and is no more or less likely to be empathetic than any other doctor and you can’t really compare their roles because they five different types of care, some that is naturally more empathetic.

I’m a mental health occupational therapist. And I do really care about my service users.

yes you’re right re the roles not being comparable.

I don’t think anyone is saying that. The confusion seems to be that the OP, and other posters, don’t realise what the role of a psychiatrist is, and that the empathy shown by one, will be different to the empathy shown from a mental health nurse or social worker. They have a very different job to do.