Why psychiatrists choose psychiatry

Last night, I came across a number of tweets with the #PsychSocTakeover hashtag. It quickly transpired that it was about psychiatrists trying to get new people into psychiatry. I didn’t particularly like the discussions, as they showed psychiatry as a specialism of clear blue sky with not a cloud to be seen. I think I wrecked some of the fun with this tweet but what I found particularly interesting was why psychiatrists chose psychiatry. And this is what this blogpost is about.

Before I comment, I want to be clear that I genuinely don’t want to put a value judgement on people’s responses, even if I make some fun of them below. Even though I am surprised with some, I can understand them. Some I would have happily given. Incidentally, if ever I had become a medic (gosh, how my father wanted it – my grandfather was a doctor still remembered decades after he was killed in WWII), I would have chosen psychiatry. It’s so fascinating!

I also would like to make a reservation that this is a blogpost and not an article, so I spent considerably less time on the ‘data’ than I would have done when writing a research piece. These are impressions really, rather than a rigorous account of the tweets. Moreover, I have divided the tweets into a number of groups, which sometimes overlap, sometimes they are created on the basis of different categories. Please, bear with me. I still think it might be interesting. Finally, I am not quoting any tweets – I genuinely don’t want to embarrass anyone.

1. The first groups of tweets represents psychiatry and psychiatrists as observers. These are doctors who were fascinated by what they were looking at and wanted to look some more. Psychiatry enabled a sort of medical voyeurism, as the medics looked at ‘mental illness’, something almost akin to a coconut on a palm tree, or a walrus emerging from the sea, one which astonishes you as you see it the first time. Who wouldn’t, after all, be interested in exploring the mind?

The psychiatrist is like Christopher Columbus who landed in America and saw new different things which were waiting to be discovered. Go discover – psychiatry is so fascinating, innit? I am sure that all those people who came to see Columbus were put there for his inspiration.

2. What I was particularly surprised with was that this interest in ‘the mind’ or ‘mental illness’ seemed not to be linked to any people, let alone clinical work. The tweeting shrinks’ interests seemed to be rather academic. Psychiatry was not really a specialism that treated people. It just looked at interesting phenomena. There are no people who suffer. There is pain, there is illness, there the mind, the brain and other organs. Even if you make a profound difference, there is really no particular person there.

As I appointed myself a patient advocated, I tweeted that I was delighted patients could provide psychiatry with the show it so desired (this is what I meant at least).

3. When people (presumably, the patients) appeared in the tweets, they provided an opportunity to talk to or to meet people. Even more, people inspired their shrinks, they provided stories, questions. You can also spend time with them, you can talk them. I am not going to say that patients become a little diversion for the psychiatrist. It is, however, quite unclear whether those people want to spend the time with the shrink, but there you are….

Be useful, we could say to the patient. Go, inspire your shrink! Your shrink needs you!

4. The specialness of psychiatry is also about the specialness of psychiatrists. They become detectives investigating, using judgement, unravelling the mysteries of the mind. Special skills and stuff. Things are so complicated – you can only wonder how they all do it, the psychiatrists. One wants to offer a standing ovation and, obviously, eternal gratitude for their commitment to solve the mystery of my mind. Thank you, thank you, thank you.

Time for an admission. When I was reading the tweets that I used in the abovementioned four categories, my first reaction was balking. No patients? No helping? No people who suffer? And this is why I started collecting them. But I am of the age that doesn’t allow quick blogposts. So, I reflected a little and started thinking. What would I have written? Would it have been so different? I am contrite to say that it would not have been.

As I said at the beginning, if ever I had become a doctor, I would have become a shrink. Would my motives have been different? I actually don’t think so. No, I would have been and continue to be fascinated by psychiatry. By the phenomena it studies and, yes, it treats. It’s amazing to work with the creations of human mind. The human mind’s science fiction, as a patient once told me.  I also wonder whether assurances of trying to help people who suffer so much would have struck a false chord. Indeed, I recalled interviews with psychologists who only ‘wanted to help’, but were uninterested in anything else. The helping was so false. So perhaps fascination by ‘phenomena’ is not such a bad thing. Perhaps the caring comes later. I hope it does.



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