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Are psychologists scared of their patients

Do you ever get scared of some psycho patients? #Psychologists

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Alexandra’s Answer, CareerVillage.org Team

Hi Heather,

I studied psychology and worked in a clinical research laboratory the past few years. I worked with adolescents who may have had mental illness or trauma - but I couldn't necessarily tell even after I spent 3 hours in a room with each of them. Nor could any of them detect my own struggle with both psychological and neurological illness. I feel I can give you a perspective that considers both you AND your patient equally.

You asked an extremely valid question about the field of clinical psychology. However, the way you ask this question tells me that society has portrayed mental illness in a very dishonest way for you. In the field of psychology, we spend very little time being *afraid* of patients and much more time *being afraid for* patients. I want to put you at ease, and help you reshape this fear into something that will help you be a great psychologist.

Firstly, *I want to caution you about how you write/speak about the patients you would treat.* I get the feeling from the phrase "psycho patients" that you may be in a fearful mindset about those with severe mental illness. Maybe you fear for your safety, your own mental health, or fear you won't be able to help. If you are a good fit to be a psychologist, your education will transform notions like these into a confident and passionate willingness to help these same people. Changing your mindset about people with mental illness is CRUCIAL to your success as a psychologist. It is also the fair and humane way to view people experiencing challenges in their lives they did not choose. So, when you refer to patients with mental illness, realize that terms like "crazy", "psycho", "schizo", or "insane" are NOT acceptable to say. If you choose to study psychology in college, you will learn many other words to describe people with mental illness that are both kinder and more accurate.

Remember that your patients are human beings first. They want to be loved and accepted just like you do, but have thoughts, behaviors, or perceptions that they cannot control. People with severe schizophrenia (for example) experience suicidality, extreme anxiety, unclear thinking, and may even see or hear things that other people do not. Imagine having some of these hallucinations try to tell you to do things you don't want to do, possibly even violent things. Imagine the horror this patient experiences just trying to get through their day trapped inside a brain that ill. This is a rare and VERY extreme example of a mentally ill person, but I want to illustrate that the most fear in the room is usually felt by your patient.

Mental illness is rarely portrayed accurately in pop culture and media - and this might largely be your experience with it. Movies about people with mental illness are intended to be dramatic and can exaggerate. The vast majority of those with mental illness are nothing like the people you see on Netflix and TV. Did you know that people with mental illness are far more likely to be VICTIMS of crime than perpetrators of it? Many people with mental illness hurt themselves long before they think to hurt others -- including their psychologist/therapist. Your patients are not out to hurt you, but they may speak or behave in a way you find unsettling. It's okay to feel unsettled by their expression of feelings and experiences, but realize they don't necessarily intend to make you feel unsettled. They are with you because they want your help, and it takes some people a lot of bravery to admit they need that.

I won't deny that being a psychologist can be extremely emotionally draining. Part of the job is to be exposed to the patient's suffering as you provide them help. In the end, though, you make an enormous difference for them AND for their families, coworkers, etc. You know yourself - if you can handle this balance, you have nothing to fear. Many people are totally fine navigating intense conversations with a patient, others are not, and that's okay. I chose research psychology because I knew I could NOT handle this emotionally. YOUR emotions, including fear, matter as well. Don't force yourself to go into clinical psychology if it would impact your own ability to live a normal life. However, I've never met a clinical psychologist who regretted their career choice, and the ones I know are all stronger and more empathetic human beings because of their career. I hope this is all helpful to you. You asked a simple question, but one with a lot of emotions and assumptions behind it. Feel free to comment if you have other questions about this!

Alexandra, CareerVillage.org Team recommends the following next steps:

Check out this video of a young man with antisocial personality disorder ("psychopathy") and bipolar disorder. Listen to what he says about his therapist in particular. This is a much better example of someone you might sit down with as a psychologist. He's far from a "psycho", isn't he? https://www.youtube.com/watch?v=bdPMUX8_8Ms
It's never too early to start gathering information about being a psychologist. Read scholarly articles, familiarize yourself with statistics, and ask questions of knowledgeable people. While you may not have the opportunity to shadow one yet because of confidentiality, I suggest doing as much independent learning as you can about what mental illnesses really look like. Many people with psych/neuro illnesses want everyday people to be receptive to their perspective, so learning through listening is one of the best things you can do!
As you explore, try to determine what type of patients you want to help the most. Is it children? Teens? Women? Couples? Families? Inmates? Crime victims? Law enforcement officers? Drug abusers? Maybe you are comfortable with some groups and not others, and that's okay. Many psychologists specialize in certain populations. You won't have to decide this until you reach graduate school, but it's a good way to start figuring out what your career might look like.
Similarly, try to determine if there are particular life events or mental illnesses that you want to help people work through - or ones you don't (and that's okay!). While no psychologist can cherrypick their patients, you CAN specialize. What seems most rewarding to you? What do you most wish you could change about the difficulties someone experiences?
Avoid going through life trying to analyze the people around you. It's the classic cliché for most budding psychologists to want to do this, but this isn't necessarily going to prepare you for your career. Don't be your friends' therapist. Be their friend. What you CAN do is be there for your friend, and practice developing good listening skills. Get a feel for THEIR needs. Also pay close attention to how the people around you want their struggles to be labelled or categorized -- if at all.
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Jerome’s Answer

Short answer: no.

It's very rare that you will encounter a violent patient ("psycho" is an inappropriate usage here) unless you're working in an institutional or hospital setting, and in those cases, the staff's generally well-equipped to handle whatever comes their way. Professional therapists and psychiatric doctors learn specific techniques to de-escalate and manage outbursts on the few occasions that they become threatening. If you're looking to enter this field, Alexandra's suggestions above are excellent, but you will need to discard any pre-conceived notions of mental illness gathered from the media or from others who have their own experiences and biases.
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Jason’s Answer

Hi Heather,

To address the first part of your question- it will depend on what sub field you work in. I worked with psychotic patients which is what I think you were referring to in your comment. Psychotic patients in an involuntary setting is where I worked and yes I would be lying if I said I was never scared. In ten years, I think it was less than ten times. You do not go to work scared every day if that is what you are asking.
This is such a tiny aspect of the mental health field that unless you want to work in this specific area, it is not really something that should trouble you.
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Priya’s Answer

Hi Heather,
I am a professional therapist associate. I have had clients that were physically violent, and in those moments I was scared, as any human would be in the face of violence. At the same time, the more you study Psychology and human beings, the less you view things as "psycho" in the way the media portrays it. I have had very few violent clients, and typically it was because my clients were overwhelmed or struggling. Once we were able to minimize the stimulus overwhelming the client, the danger mostly passes (at least in this particular situation.) When studying, you will learn to deescalate a crisis, making these situations less frightful than when unprepared. At the same time, no matter what, I think it is frightening when anyone gets physically violent. Outside of physical violence, I have not had an experience of being frightened of my clients. I may if a client acts inappropriately due to my gender, but, again, you will usually be aware of the protocol and boundary setting to minimize uncomfortable experiences. Typically, any experiences like this are not the norm in the settings I worked in. You may feel frightened when seeing a particular disorder, like a psychotic disorder, for the first time but once you gain experience and knowledge, your preparation and experience will help you see that many times these clients are not harmful, or are as harmful as anyone else in the world. Everyone is different so the same disorder does not necessitate that some particular behavior comes from that person. Also everyone is human! Good luck, and happy learning!
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