the Lack of Empathy in Psychiatry: A Patient's Perspective - Psychiatry

Why is the attitude of psychiatrists like this?

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Here are my reflections on my interactions with psychiatrists, and I would like to share them with you and, if possible, receive some feedback.
I feel that some psychiatrists lack appropriate empathy; they seem to believe that medication alone is sufficient, and that any issues are merely a matter of self-confidence.
They fail to recognize that some patients experience a decline in their abilities and continue to pressure them to work or engage in activities beyond their capacity or stress tolerance.
They do not take the time to understand the patient's condition; instead, they want the patient to quickly behave like a typical person and engage in normal activities.
When a patient tries to explain their situation, the doctor insists on their own beliefs, such as assuming that a psychological evaluation indicates average intelligence, which leads to the erroneous conclusion that the patient is stubbornly insisting they have problems.
This is akin to pouring salt on a wound—a double blow.
Telling someone with depression to simply "cheer up" is no different.
Just because an intelligence test shows no issues does not mean the individual possesses the same capabilities as a typical person.
The doctor is aware that long-term mental disorders can lead to cognitive dullness, varying in degree, but it exists nonetheless.
Furthermore, I wonder if the doctor has ever undergone a psychological evaluation themselves.
Do they understand that psychological assessments are inherently limited? Being able to recall an 8-digit number backward does not necessarily indicate good memory in daily life.
I don’t understand why, if doctors have experience with patients in chronic care, they wouldn’t recognize that some individuals experience a decline in certain abilities.
Some patients find it difficult to play chess or board games because they perceive them as too complex, or they struggle to follow conversations if the other person speaks too quickly or uses topics or expressions that exceed the patient’s usual comprehension.
Some patients cannot understand movies, and if they cannot follow the dialogue without subtitles, they may be unable to watch films at all—tasks that most people find easy.
However, those whose abilities have declined may communicate similarly to typical individuals, appearing cognitively normal and engaging in simple conversations.
How can doctors assume that because they see no issues in basic dialogue, the patient possesses the same capabilities as others? Isn’t the conversation between the doctor and patient typically quite straightforward? These doctors cling to their misguided beliefs, insisting that the patient is stubborn, while they themselves are being inflexible.
Do they truly want to hear the patient’s explanations? This attitude is fundamentally harmful to patients.
It gives the impression that anything beyond their training is dismissed and not worth understanding.
With 7.7 billion people in the world, there are 7.7 billion mental states; people cannot be easily categorized.
Depression is not just one thing, schizophrenia is not just one thing, and bipolar disorder is not just one thing.
Just because something exceeds the doctor’s training does not mean it does not exist.
They should listen more to their patients.
It is not accurate to say that a lack of understanding equates to depression.
This is simply not the case.
It is not only depressive states that can lead to cognitive sluggishness or impaired logical reasoning, nor is it solely ADHD that causes these issues.
This perspective fails to explain the experiences of many chronic mental health patients.
For many chronic patients, emotional symptoms may be well-controlled by medication, but their cognitive abilities may not return.
Intelligence tests do not fully represent the brain's cognitive functions.
I don’t understand why psychiatrists, who should be aware of this, maintain such an attitude towards patients.
Initially, when I tried to explain my situation during an outpatient visit, I was immediately rebutted in a rather rude tone, which made it increasingly difficult for me to express myself as the appointment progressed.
It felt as though the doctor established a boundary, suggesting that anything beyond that boundary should not be discussed.
I do not expect too much from psychiatrists, as their training primarily focuses on medication and physiology, and their main role in outpatient settings is to prescribe medication.
While certain psychological explorations may not fall within their scope of work, I still hope they can exhibit more empathy.
At the very least, they should strive to understand their patients better, rather than dismissing their concerns and carelessly uttering hurtful remarks.
This is simply unacceptable.
For patients experiencing cognitive decline, coercion is not an effective solution.
Forcing them to engage in activities will not yield the training or rehabilitation outcomes they believe it will; sometimes, it can lead to further withdrawal.
It is essential to understand the patient first before making any judgments.

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Xuan, 20~29 year old female. Ask Date: 2022/07/07