An intern rotating in Psychiatry asked me why I talked differently each time a new patient comes in. I gave a short pause recalling all the number of times I had to explain why I do it so much that it becomes second nature.
It's supposed to be part of the skill set in this profession otherwise you fail miserably if you stick with one mask for all patients. If you're in a good mood and it shows in your face, a patient on their depressed mood may find it irritating, a paranoid patient may find you suspicious, and a psychotic patient may find you who knows what. So you have to read the room or person in front of you to be therapeutic for them to talk to.
I couldn't recall any instance where I had difficulty seeking cooperation from even the most obstinate patient just by doing this. I'm not saying it never happened, I'm saying most of the time, it's easy to seek cooperation with people if you know how to pick up on their social cues. The shortest way to get someone to agree with you and cooperate is identifying a common goal and communicating how you also want what they want to happen too.
In a way, even with mentally stable people, you still notice some conversational approaches that work well with your friends and some don't. People customize their approach depending on the individual they meet and it's an unconscious act but it's more pronounced in my job because we have to constantly mind ourselves to be responsive to people in front of us.
For people that don't have good social skills, it's understandable that the method of wearing different masks seems like being manipulative but it's just being tactful. There are intrusive thoughts and feelings you keep to yourself and don't even want to share with your significant others too. But failure to see this as your own version of a social mask and calling others who are proficient at it fakes is just hubris. Do you really think that that bank teller smiling at you was genuinely happy to see you or are they instructed to smile in front of you? maybe. Maybe that stripper was happy to see you?
Do you really think that your friends are in good spirits when they're around you? unbothered by their own mortal woes that it doesn't show in their face and tone? all the time?
Like I said, it's a social skill to tailor how you talk depending on who you're talking to and some people's livelihoods are based on this crucial skill to be effective. For some people who have the luxury to be true to themselves at all situations without social repercussions, you might see them having less friends, or live a privileged status in life where they don't need to participate in the rat race.
In a situation when I'm with friends and they comment how I can be untherapeutic at times my response would be "you're not my patient, I'm not thinking about my interaction with you as part of my job, and if I don't have that security to be able to talk shit in front of you about my mortal woes, then I should reconsider the label of you as my friend".
If you're talking to a mentally unstable patient trying to calm them down, you try to be less threatening with your tone and nonverbal movements. But this is easier said than done especially for people who have less experience talking to someone with a deranged mind. I had a patient threatening me with a sharp object or getting ready for a brawl, instead of panicking I just calmly move unhurriedly and try to verbally deescalate while the rest of the bystanders and interns move away real quick as soon as the patient threw a tantrum.
I think people who have less to no working experience in customer service wouldn't get this intuitively. In customer service, you meet different people carrying different senses of entitlement and you have little choice but to negotiate with them. It's like intentionally having your hands tied behind your back when you're engaged in conflict. No matter what happens, you try your best to be professional and not come across as rude when you're being tested because your job depends on it.
Again, it's an innate skill everyone has been doing except some people are good at it because their job depends on it or they have a knack for it. If you feel that this is a form of breach of trust because the other person wasn't being true to themselves, maybe examine how many interactions you did for the past week that you had to held back a little about yourself because it didn't fit the atmosphere.
Thanks for your time.
That intern probably didn't realize that he probably does it in his own social interactions outside of work.
I think they now do. They and like most people, probably took this skill for granted since it happens daily and natural. It's just more pronounced when you're actively trying to "match" your energy with someone because it's a job rather than leisure talks.
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It could be said that it is a social communication technique that consists of flowing with the environment of the conversation by intuitively having a sense of touch so as not to disturb the environment or subtly change it.
It’s for sure really important that we try to be genuine and figure out how to work best with people. It’s not always easy and it’s also not always successful but it’s important to try. There’s enough challenging stuff in the world - it’s good to try and make that one less thing others have to deal with negatively!
This is a really interesting perspective,@adamada!It's fascinating to think about how we tailor our communication based on who we're talking to.I can definitely see how that's essential in your profession,but it's also something we all do to some extent in our daily lives.You make a great point about the difference between being manipulative and being tactful. It's a fine line,but I think it's important to be aware of how our communication can impact others.I'm curious to hear more about your experiences in psychiatry – it sounds like a challenging but rewarding field.
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