HMN 2024: Psychiatrists Suffer Too |

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Psychological Pain

Psychiatrists are human. They are just as likely to develop psychological pain as the rest of us. On top of that, psychiatrists have to spend a high proportion of their professional life listening to the sufferings of others, with no respite to look forward to other than the periods spent on demanding administrative duties, which may be equally trying.

In addition, psychiatrists can feel traumatized when a patient commits suicide or takes somebody else’s life. They may, on occasion, be held responsible for the actions of a patient, a worry that can induce many sleepless nights. They not only deal with work pressure but also with sadness, risk, fear, and violence every day of their working lives.

No wonder they suffer. Tragically, some of them even take their own lives. The rate of suicide amongst mental health workers is thought to be considerably higher than that of the general population.

I was a psychiatrist for many years. I still look away, or even leave the room, when someone is about to commit suicide in a film or TV drama. And I still wonder how I coped with all that pressure and all that sadness.

Compassion

A psychiatrist is not immune to the suffering of his patient. If they are compassionate, and in my experience, the vast majority of them are, they will feel their patient’s pain, which isn’t pleasant. There were mornings when I woke up wishing I had a more cheerful occupation, like selling flowers or planning weddings.

But compassion is a necessary quality in a psychiatrist. When we are sick, we want to be treated by a competent and compassionate caregiver, not only because this will humanize the healing process but also because a doctor who has the capacity to empathize will also be better able to understand what is happening to us, which in turn will help them find the best cure.

But there is a problem. Compassion is a very human emotion that is influenced by the personal and social characteristics of the patient. It is believed that compassion developed as a result of a specific evolutionary demand to protect our own tribal kin, a very different task to that of deciding who should have expensive investigations or be admitted to an acute bed.

Research has shown that the traits that generate compassion are tribal or group membership, affective warmth, and perceived helplessness. The problem is that some chronic psychiatric patients may be perceived as aloof, or even threatening, and therefore lack the characteristics that would naturally elicit compassion. These patients may therefore potentially miss out on the benefits associated with a compassionate treatment.

Even if we accept that a lack of compassion in such a situation would interfere with fairness, it will still be undesirable and probably impossible to exclude this emotion from a psychiatrist’s interactions with his patients. Psychiatrists could try to transcend their feelings of compassion by acknowledging them with intellectual skepticism while allowing more logical and objective considerations to be part of their decision-making, but it is much better to actively cultivate compassion in their minds towards those who are unable to bring about this feeling in others, which is itself a sympathy-deserving handicap.

Unfair Social Image

Psychiatrists are often portrayed in the media as authoritarian agents of the state who can’t wait to lock up patients against their will and damage their brains with aggressive interventions. In reality, they are desperate to improve their patients’ health and normalize their lives as much as possible, and they often suffer considerably in the process.

Spare a thought for your psychiatrist if you have one.