Everyone Ought to Learn Some Psychiatry
On Wednesday evening my students came to visit me. One of them had just been admitted to Beijing University of Chinese Medicine. I gave her three books: "I Myself, My Brain," "Cognitive Behavioral Therapy for Personality Disorders," and "The Psychiatrist's Handbook," and asked her to read them in her spare time to learn some common psychiatry. Because in a few years she will become a clinician and will encounter all kinds of difficult people at work.
Some U.S. medical textbooks have compiled statistics on the difficult patients physicians encounter daily: among people seen in routine work by a non-psychiatric physician, 15% have mental problems. In fact this figure may have risen in recent years. Based on trends in human disease, the WHO estimates that by 2030 depression will become the number-one disease in the global burden-of-disease ranking, surpassing today's cancer, cardiovascular and cerebrovascular diseases, and COPD. This means physicians will encounter more and more people with mental problems at work.
When encouraging my student to open the door to psychiatry, I told her that as a physician she should be compassionate toward all patients and not discriminate against them, but she should also understand that mentally ill patients may cause her considerable distress, which could in turn leave her own psychology in a sub-health state. After we have studied psychiatry, we can view patients' words and behavior from a pathological perspective and not take things personally. This not only helps patients but also helps the physician maintain her own mental health.
The two professions that encounter the most mentally ill patients are physicians and police officers; people in these two occupations bear greater psychological stress than those in other fields. Physicians and police encounter unpleasant people almost every day; many have emotional reactions clearly abnormal to normal people, yet are themselves completely unaware. Most of these are psychological or mentally ill patients hidden among the crowd, undiagnosed and untreated. After learning the relevant knowledge and diagnostic skills, we can better identify such people.
Once we have learned the relevant knowledge, we can also understand the biological neurological principles behind their words and actions, so as not to react emotionally to their abnormal behavior. This can greatly reduce the harm we suffer at work and avoid escalating conflicts and more serious confrontations.
Many behaviors of mentally ill patients are beyond their control, but if clinical workers understand the characteristics of these illnesses, they can avoid provoking them, better control the situation, and prevent many disputes. I have studied the sensational doctor-patient disputes of recent years; most were triggered by people with mental illness.
Physicians, regardless of specialty, should all learn some common psychiatry. If, after learning psychiatry, one has the ambition to work in the psychiatric field, one can even use that knowledge to help patients recover. This was my original intention in asking my student to study psychiatry.
A major shortcoming of modern society is the lack of kinship bonds between people. Over the last one or two hundred years, humanity has basically destroyed the kinship networks built by our ancestors out of various relatives. Modern people mostly lack spiritual support; someone like me, who grew up in an environment where people were closely connected, feels this very deeply.
Now everyone lives in a concrete jungle; relatives and friends rarely visit one another. Most people's emotions can no longer be smoothed by close neighbors or relatives as in the past, so psychological stress has become very common in our era. The renowned sociologist Mr. Xu Zhuoyun conducted in-depth research on this issue; the phenomenon he observed in the United States of how broken kinship affects people's inner worlds is now spreading worldwide. Mentally ill patients, once rare, are now common.
In this social environment, not only physicians and police but actually every ordinary person needs to learn some psychology and psychiatry. People often come to me for counseling after encountering extremely unpleasant things at work or in life; these problems mostly arise from conflicts with others, and the vast majority of interpersonal conflicts are actually driven by mental illness.
If someone makes more than 15% of the people around him uncomfortable, that person most likely has a psychological problem or mental illness. Some mentally ill patients recognize their own problems and actively seek treatment, while others blame the outside world and always feel they are the ones in the right. Sensitivity, suspiciousness, irritability, depression, mania, anxiety, hypochondriasis, fear, and excessive emotionality are mostly signs of mental illness. But because of the long-standing stigma around mental illness, the treatment-seeking rate among Chinese mental patients is markedly inadequate.
Mental illness, like physical illness, is a physiological illness; society should not discriminate against the mentally ill. The medical community should do more popular science to promote public understanding, sympathy, and acceptance of the mentally ill, and help them recover and improve their quality of life. But mental illness is also a very special kind of illness: it affects the patient's interpersonal relationships and causes harm to the patient and to others.
Many mentally ill patients are unaware of their condition; they are sick but do not believe they are sick, instead blaming the outside world, rarely or never engaging in self-reflection, and lacking people around them who care for them. This causes their condition to worsen. Some mentally ill patients, in the final stage, may harm themselves or commit suicide; others are highly aggressive and may harm other people.
To survive in this society we must adapt to this reality. If we work in medicine or public security, we must pay special attention. If we ourselves have psychological problems or mental illness, learning the relevant knowledge can also help us better manage our own lives and reduce damage to relationships.
Facing mental-health issues squarely is an important sign of social progress. Many of today's online hotspot events are actually caused by mental illness, but unfortunately they all end in online mob harassment. In a civilized society, the public should hold a forgiving and sympathetic attitude toward the mentally ill. Ordinary people, even if they cannot help them, should not discriminate against or harm them.
The broader a person's knowledge and the greater his reading, the calmer his mindset. So far I have found no method more calming than learning. So, if you are also interested in reading, why not pick up a few books on psychiatry? Perhaps once you open this door, you will understand the various people and phenomena around you better, and your own emotions will become far more stable.