Fascinating Insanity, or: Why I Loved My Psych Rotation

So today was my last day of clinical responsibilities for my psychiatry rotation.  Psychiatry was something that, with the exception of a personality conflict with one of my instructors a couple of years ago, I’ve really enjoyed learning about, so I was excited to do this rotation and see if I enjoyed it clinically.

I do.

It’s absolutely fascinating to me to see how much mental illness can affect a person’s perception of the world, and in what ways.  I’ve worked with patients with depression, bipolar disorder, schizophrenia, substance-related disorders, borderline personality disorder, narcissistic personality disorder, PTSD, and even a patient with paraphilic infantilism.   I saw some of these patients get much, much better with therapy.  I saw some who were unable to recognize their mental illness.  I saw some who had problems they recognized, but weren’t willing to participate in therapy for.  I saw some who desperately wanted help, and for whom we just hadn’t found the right therapy for.  And I saw some who struggled with a therapy that ameliorated the symptoms of their mental illness, but were struggling with side-effects of the treatment.

Through all of this, I got to see people as they really were.  I saw this on my pediatrics and internal medicine rotations, too, but not to the degree that I experienced it in psychiatry.

It became a great opportunity for introspection, as I worked to recognize counter-transference, and to assess what it said about me, or as I cultivated empathy for my patients, and tried to see the world as they saw it.

I think you need to have a bit of a light attitude about it all, to be able to maintain the energy you need to continue helping patients with problems that are, often, extremely depressing/frustrating/frightening for the therapist, and more so for the patient.

Ultimately, I loved psychiatry because it was, more than almost any other time of my life, an opportunity for me to focus my efforts and attention on people, in spite of their problems, because in this case, the two are not truly separable.