The main illness in the field of clinical psychiatry, like schizophrenia, mood disorders and psychogenic disorders don't have any biological markers to objectively identify and evaluate their qualities. It is well known that the daily clinical work of psychiatrists basically consists of visual observation and listening to perform diagnosis and treatment. Therefore, a psychiatrist is not just a doctor who administers some kind of therapy and pills, the true role of a psychiatrist comes before that, and involves observing and listening to the patient from a psychiatric perspective. We must remember that a psychiatric perspective is not limited to a list of symptoms, or a chart of illnesses. It is an approach that tries to understand the patient's way of living and being, including their personality.
This paper will focus on listening to introduce the basics of listening as a psychiatrist, and how to acquire it.
First, we must know what to listen for. It can be broken down into 6 categories: 1) Listen to the content of the patient's speech. 2) Listen to the form and format of a narrative. 3) Listen for the thought level of the narrative 4) Listen to their manner of speaking. 5) Listen to the unconscious context within their narrative. 6) Listen to our inner voices.
To achieve these different qualities of listening, we need to acquire basic supportive and empathetic listening. And it can be achieved by establishing 4 steps of practicing the different ways of supportive listening.
Step 1: Take on board what is being said and expressed as it is, and go along with it, without trying to clarify or reinterpret it.
Step 2: Spatially separate yourself from the other person, and listen objectively.
Step 3: Savor and listen to the patients'experiences, feelings and thoughts as your own.
Step 4: Perceive, in the finer details of the story, the gaps between yours and the patient's same thoughts and feelings.
<Author's abstract>
How Do We Listen to Become an Efficient and Productive Clinical Psychiatrist?
Chihaya ACT Clinic
Psychiatria et Neurologia Japonica
120: 488-494, 2018
<Keywords:psychiatric listening, supportive listening, empathy, psychoanalysis>