psychiatrist

They are professional service providers who have received at least 3 to 8 years of systematic training and can provide customized intervention plans according to the different conditions of visitors. They are neither "spiritual mentors" who just pour out chicken soup, nor are they "miracle doctors" who can "cure" all pain with just a few words.

Last week, a sophomore girl in high school uniform came into my clinic. She sat down with her head lowered and her first words were, "Doctor, please don't persuade me to prescribe more medicine. My parents have said enough." She has been suffering from insomnia for more than three months. Before each mock test, her hands were so shaking that she could not hold the pen. She even had trouble reading questions for half an hour in the exam room. The school psychologist suggested that she come to the hospital. She thought it was the same thing as the last time the teacher took her to a ten-minute chat and ended with the sentence "Adjust your mentality."

In fact, what many people refer to as "psychiatric consultants" is a vague general term - psychiatrists are those who consult in the psychiatry/clinical psychology departments of public medical institutions and have medical qualification certificates and prescribing rights. In addition to psychological intervention, they can also prescribe psychotropic drugs according to the condition.； Those who only provide non-drug interventions and do not have the right to prescribe are registered psychological counselors. The two types of practitioners have different training backgrounds and service scopes. Usually, everyone keeps arguing for a long time, and then misunderstandings arise, such as "Why don't you prescribe sleeping pills for me?" "Why do you only chat and don't treat me?"

Don’t think that when we do consulting, we all follow a set template. Take the situation of the little girl just now. If she is looking for a counselor of the cognitive behavioral school, she will most likely be given an emotion record sheet first, asking her to write down the thoughts and body reactions that come to her mind every time she has an anxiety attack. First, she will lower her emotional peak before the exam, and then slowly correct her absolute thinking of "if she fails the exam, she will be doomed for the rest of her life." ； If you are looking for a counselor with a psychodynamic orientation, you may first chat with her about whether her parents' requirement of "must get into the top 10 in the exam" since she was a child made her tie her test scores to "am I worthy of being loved". There is no final conclusion on the "optimal treatment" in the industry, and adapting to the needs of visitors is the first priority - some people are tired of digging up their childhood memories, and want to first solve the current problems of not being able to sleep and not being able to take exams. Short-term cognitive behavioral intervention will naturally have faster results. If you insist on talking about childhood trauma, it will easily arouse resistance from the visitors.

I once gave birth to a mother who was four months postpartum. When she arrived, she didn't even have the strength to raise her hands to wipe away her tears. She said that she only felt annoyed when looking at the child in her arms. She even had the thought of "it would be better if she didn't have this child." She cried at home for almost a month and did not dare to tell her family for fear of being called "hypocritical." I gave her a scale assessment and found that she was at a moderate level of depression. I immediately referred her to a colleague in the psychiatry department who first prescribed medication to regulate neurotransmitter levels, and then cooperated with weekly consultations to help her sort out the conflicts between mother-in-law and daughter-in-law and the emotional stress of her husband’s absence after giving birth. When she came back more than two months later, she would tell me with a smile that she took the child for a walk in the community yesterday and exchanged complementary food formulas with the mother downstairs. Many people always think that "taking medicine means they have a mental problem", or that "depression can be cured by chatting alone". In fact, this is not true - mild emotional distress and adjustment disorders can be alleviated through consultation, but for moderate to severe depression, anxiety, bipolar disorder and other diseases, it is a more reliable solution to first bring the physiological abnormalities back to the normal range with medication, and then perform psychological intervention. There is a high degree of consensus among practitioners from different schools on this issue.

When many friends know that I am in this business, their first reaction is, "You listen to other people's complaints every day, how can you not hold it back?" In fact, it's not bad. After all, we also have our own supervision and personal experience, and there are many ways to digest emotions. What impressed me the most was a visit last year. When I came for the first time, I didn’t even dare to enter. I stood in the corridor and hesitated for 20 minutes. I said that I didn’t dare to talk to strangers for half a year. Even going downstairs to buy a bottle of water required half an hour of psychological preparation. I have been consulting for seven months. Last week, he made a twenty-minute detour to come downstairs of my clinic and gave me a box of cookies he baked. He said that he went to see his favorite band’s tour alone last weekend and stood in the front row and shouted until he became hoarse. What can I say about that feeling? It's like watching a wrinkled seed slowly sprout on its own. That sense of accomplishment is really something that other jobs can't give you.

Oh, by the way, there’s another point that many people misunderstand – we really won’t help you make decisions. Last time a girl came to consult me ​​on whether to break up with her boyfriend of five years. She sat there crying for two hours and asked me, "Do you think we can break up?" I didn't give an answer, so I just asked her: Why are you afraid of breaking up? Is it this person you can’t let go of, or is it the five years you’ve invested in it? If there is no separation, can you accept that he will continue to play games every day and not reply to messages in the future? At the end, she wiped her tears and said, "I know, I just don't want to give in." Half a month later, she sent me a message saying that she had moved out and went hiking with her friends over the weekend. She had not been so happy for a long time. After all, you live your own life, and none of us are qualified to choose for you. The most we can do is help you wipe away the fog that blocks your eyes. You still have to walk your own way.

To put it bluntly, our industry is more like a "psychological escort" - if you fall into a pit, we will not stand on the edge of the pit and shout condescendingly, "Come on, climb out", nor will we directly jump down and carry you up. After all, if we climb out for you, you will still not be able to climb out by yourself next time you fall in. We will only squat down and accompany you to see how deep the pit is, and look for any stones that can be stepped on or grass roots that can be grasped on the side. When you have gathered enough strength, we will slowly climb out with you.