Challenging the Perception that Psychiatrists are 'A Little Robotic'

When I think of the word “demoralizing,” I used to think of that feeling when you wash your car and it rains the next day. Then I was searched through my insurance company’s list of psychiatrists in my area.

It’s hard to communicate the depths of my exasperation at seeing review after review decrying absences of compassion, humanity, and listening. Of any branch of medicine, psychiatry — which, you know, specializes in diagnosing and treating oft-stigmatized mental health disorders — should be one devoid of those challenges, always approached with thoughtfulness and care.

Yet here we are. It can be brutally hard to find a psychiatrist who is right for you.

One thing, it seems, that would go a long way toward strengthening ties between people living with mental illness and those clinicians who are trained to offer them help: Plain, simple human connection. A reminder that on the other side of the line, our mental health professionals are human beings themselves.

With the topic of humanizing in mind, I spoke with board certified addiction psychiatrist Dr. Bruce Bassi, MD, MS, medical director of Telepsych Health, an online psychiatry practice — and host of the new Future Psychiatry podcast — about how he approaches his job:

The Mighty: What initially drove you to pursue this line of work?
Dr. Bassi: I started off as an ER physician and when seeing patients, I saw clear psychosocial factors contributing to a patient’s presentation but in this ER setting we were not supposed to focus on them. We needed to instead focus on the medical factors that either rule in or rule out an emergency. Makes sense, but in my mind, talking about the psychosocial elements was way more natural to me and impactful to them, since this was often the inciting reason for the ER visit anyway. I decided to switch and am so happy I did.

How do you manage your own mental health?
In one word: balance. I try to spend time with family, exercise, go out to eat, go out for walks, and work on a little passion project of mine — a podcast I started called “Future Psychiatry” where we talk about tech and new innovations in mental health. I feel so lucky that it doesn’t feel like work for me, so in that sense, I’m never working.

Is there one misconception about psychiatrists that you most want to challenge?
In movies and shows, I am always a little embarrassed when psychiatrists are portrayed as cold and socially awkward. No, we are really not like that! We are normal people too, with our own ups and downs and real feelings. Psychiatrists are taught, traditionally, to never disclose personal details in a session with a patient since it interferes with the patient’s own self-analysis. This thereby contributes to the perception psychiatrists are a little robotic. Appropriate self-disclosure is a very fine line — it can easily be construed as insensitive, self-centered, too much, or poorly timed. So I think to err on the side of caution we don’t disclose much, and that can work against us too.

The last time you thought “wow, I love this job” … what prompted that moment?
Honestly, I have that moment every day, it feels hard to believe that I make a living talking to people about what is interesting to both them and me. The patients are incredibly appreciative too. We try to give patients a better experience, respect them, and add more empathy to the process of seeking care and people have been yearning for that.

The last time you thought “wow, this job is SO hard” … what prompted that one?
Sometimes people share experiences with me that are so traumatic and unjust. I can be left speechless not knowing what to say. I remind myself that in the moment I don’t need to fix it, but just share in the experience with the patient and let them know they are not alone.

Let’s say you were given 5 minutes of airtime during halftime of the next Super Bowl to teach the general populace one important mental health concept. What’s the topic of your lecture and why?
That’s a really cool question. Predicting suicide risk is still incredibly hard for clinicians so I would use that time for public health education on suicide prevention resources such as the new 988 crisis line. I want everyone to know there isn’t any justification to taking your life or someone else’s life. Your brain may trick you in the moment, but many suicide survivors often share that they are so grateful they were unsuccessful, and they go on to lead very fulfilling lives. In your lowest moments, you just need to lean into as many resources as possible.

One more wild hypothetical for you: If you could wave a magic wand once with the goal of changing one thing that’d improve mental health for as many people as possible, what would you change?
That’s a tough one, but I think I’d wave my magic wand at the whole reimbursement structure in the US. Reimbursement issues with insurance and federal payers — like Medicare and Medicaid — is what drives so many psychiatrists and therapists to operate cash-only practices, which cuts off access to care for everybody but the wealthy. There’s a nationwide shortage of clinicians to start, and it’s even worse when you consider many of them are cash only.

Thank you to Dr. Bassi for being so generous with his time — and for using his theoretical airtime and magic wand wave in such helpful, productive ways. If you’d like to learn more about Dr. Bassi’s practice, visit Telepsych Health here. You can also watch the first episode of his new podcast, Future Psychiatry, on YouTube here.