To think most psychiatrists are quite cold

[Forpetslikethecats]

Just that I’ve had psychiatrist from around the age of nine now in my late 20’s and most have been cold and uncaring

I've had a few and psychotherapist.. for 40 ( im 67)years on and off and felt this way except for one female who was my age when l was 50.. and l walked out.. she was very patronising... but the rest ( all Male) have been absolutely brilliant.
Last one a year ago was the best ever.. l had 26 weeks of CAT therapy.

From the point of you for someone who works in mental health, psychiatry is still a very medicalised approach so psychiatrists tend to be more to the point and detached as they are usually just diagnosing, prescribing medication etc… they often are responsible for a very high number of patients. I think psychiatrists and psychologists often get confused as it is psychologists who will do the emotional work and need to build rapport etc…

Long term mental health issues, had 2 excellent psychiatrists, 2 appalling ones and everything in between. You can’t just write off an entire profession built of individuals

A female one I had was pretty warm and kind seeming. But it didn't really matter that much if she was pressing me into a treatment I was too scared to do voluntarily. There was another one where I felt like she didn't even understand a word I was saying. Which was annoying and scary.

My DD has also been seeing psychiatrists since she 8-9, also autistic. She’s 20 now and we’ve seen, I think 7 psychiatrists. They’ve all been at least OK. Some nicer than others, but all fine.

The most detached one was the one who was the most help; he prescribed a medication that significantly helped a long term, seemingly untreatable problem.

My most recent one is lovely and has gone above and beyond for me. He was there for me when I didn’t have anyone else in the world.

Ive probably only met a couple who have any apparent inter personal social skills, Ive never been a patient of a psychiatrist but have worked professionally with many supporting children and their parents, and whether they're part of the health team around the client or whether instructed by the courts, penny to a pound they're nearly all quite cold, often quite dismissing, demeaning at times.

I would suggest it’s due to the sheer amount of diagnostic criteria they are trying to weigh up while speaking to you. They have stringent clinical parameters they need to be thinking about, and extracting the info they need takes detailed, specific questioning. It’s a clinical interview, not an informal chat.

I think that one of the problems is as another poster has said, they are rigidly within the medical model, they seem to know very little about attachment behaviours or disorders and find it difficult to view traits, symptoms behaviours and personalities holistically with other aspects of the clients life.

DD’s gf is a psychiatrist. She’s lovely and warm and friendly.

Its a difficult job though.

They are individuals. Some are cold, and some are not. My own consultant psychiatrist is really nice... very easy to speak to. Feels like talking to a friend.
I have met some MH nurses that have been cold and utterly vile. If your compassion fatigue has reached a point your service users notice, then you need a new job.

I'm a mental health nurse, and find it's very dependent on personality! Imo, being personable and warm are fundamental qualities for anyone working in psychiatry. Your job is literally to talk to people about the most vulnerable parts of their life. Good relationships with mental health professionals are important. It's not like other areas of medicine imo. Research studies will tell you people have better outcomes in things like therapy if the patient/therapist relationship is good.

A huge part of my job is holding the space for people, and treating people with warmth and compassion. I always focusing on building a good rapport with new patients.

Patients are not my friends, but it's a very human job and people want to deal with someone who feels real. Who would want to disclose their childhood trauma to someone who seems detached? I use appropriate self disclosure, and I take an interest in people's hobbies and lives. I remember the details people tell me. I'll have a joke with people. It's all about getting to know the individual and being person centred.

I find it odd that some people equate being cold as being professional. I actually think it's unprofessional. You should be trying to put people at ease. You can be personable and warm whilst maintaining professional boundaries.

But back to psychiatrists- they see patients less so won't build the same relationships I do with patients, but I'd still expect warmth and an attempt to seem human/personable and not just sound like they're asking a bunch of rehearsed questions. Psychiatrists also work within a medical model, which will make things seem more detached at times.

(There are some cold/awful MH nurses too!! As I said, very personality dependent!! I do wonder why you'd go into the job though if you don't genuinely enjoy talking to others and building rapport!)

I agree it is a really difficult job and they have to make life and death decisions every day especially with so little resources in the NHS. It’s easy to say with hindsight that they made the wrong decision if a patient takes their own life so they can’t win.

That’s like complaining a plumber knows nothing at all about rewiring a fuse box though. Totally different skill set.

I doubt your psychotherapist can explain how to investigate and manage neuroleptic malignant syndrome either, or identify a prolonged QT interval on an ECG. Your medically-trained psychiatrist will be able to.

I wouldn't say cold..... very matter of fact id say. And from what I know now, was/is autistic. But amazing!!!! That guy saved my life and ill always be eternally grateful to him.

My dad is a psychiatrist and is warm and friendly. He isn't like that at when he is diagnosing a patient / meeting them at their first appointment. He holds back so can see what is going on.

I on the other had work in emergency/trauma medicine. I'm extremely outgoing and try to put the patient and family at ease.

The one I saw was horrible. Used to make me feel worse when I saw her.

They can be depends on their model of therapy also.

Psychodynamically trained ‘old school’ medical model leaning can be very detached - blank faced, it can be quite unnerving.

Where as other models may support a warm rapport and seem more open.

I’ve sat and cried with clients - there are times it’s appropriate to communicate healthy emotional reactions to content.

4 of my friends/family are psychiatrists (but obviously not had the need to use the services of one) none of them are cold or uncaring, but they aren’t your friend, they are paid to do a job.

My husband is a psychiatrist. He isn't cold at all but I think most doctors develop a shell or persona to get through the day and to gain some detachment from their patients. I don't think they could keep doing the job if they couldn't do that. They still feel things though. Its strange actually as I usually him as his usual funny warm self but he sometimes slips into his professional persona and it is quite different. He once early in his career discharged a patient who went straight home and killed herself which nearly broke him. It isn't an easy job and I think they do their best to try and help while not getting ground down and made unwell by the state of things themselves.

We had one who spoke to us with his eyes mostly closed!

Its interesting to hear this perspective. Presumably he has lost other patients to suicide since then but learnt to not let it affect him so much? It’s pretty much an occupational hazard of the job?
I always think it is so unfair to blame MH professionals for discharging a suicidal patient who does kill themselves as there are so many of them and it’s easy to say it was the wrong decision after the fact.

It isn’t unfair at all. They’re clearly negligent and shouldn’t be doing the job if they lose patients.They're paid enough and we don’t just just shrug our shoulders if patients die after negligence in any other part of the NHS. That is why there are so many shite psychiatrists and it needs to stop. How would you feel if it was your son or daughter?

Unlike therapists/counsellors , they are not there to give you a “professional cuddle”. They are there to provide a medically qualified view.

Of course he has and it does get easier but its never easy. He wasn't blamed for it happening but he did have to write a report on his decision to discharge the patient, which is standard. How he felt about it himself was another matter.