Why see a psychiatrist in person?
Psychologist studies show that about 80% of communication is nonverbal. That means what a person communicates is 80% gestures and facial expressions and all these nuances involved in human communication. Just 20% of communication or maybe even less is simply the words you use.
Communication is also two-way. You are communicating to the doctor and the doctor is communicating to you. How well does the doctor pick up on the nuances of what you say? We communicate emotions with those nonverbal cues. We might say I am doing OK, but we are looking down, and our facial expressions are flat and there is a lot of tension in our voice. We might even avoid eye contact with the doctor to communicate we’re not feeling comfortable with the topic of conversation–because it is a critical emotional issue. But in fact, that’s because the topic is exactly the area of pain a patient is experiencing. This happens all the time. Does this make sense to you?
Let’s say a person is having a hard time getting over a break up with a significant other. There might be other losses associated with that, such as alienation from friends, loss of a pet, loss of property, loss of reputation with friends, and losing the hopes and dreams associated with that other person. All of this might be so painful that the thought of talking about it will make the pain worse and the pain might be unbearable with a person occasionally crying or missing work due to the high stress. In this kind of situation you might want to do an online visit, which might allow you to say oh I’m doing fine, when the psychiatrist asks how things are going for you.
You know he won’t pick up on your eyes and facial expressions.Your secrets are safe with you. But you broke the ice and at a certain point in the future, when you are more comfortable with seeing a psychiatrist in person, you can do it. You broke the ice. And for now your secret is safe with you, but your pain and the cause of your pain has started to be addressed. Commonly I’ll see someone, they say everything is fine, but they brought someone else with them, or someone else is available by phone. I might call a Mom or Dad or friend, who says what is really going on. “We’re worried about Dan because he hasn’t been coming out of his house for days now.” See how easy that is? Your friends can help you alot.
So it’s often a good idea to see a psychiatrist in person at least for the first time or one of the first times. This is a big deal. You are investing in your future. You can establish a relationship. He can get to know you and you can get to know him or her. Too often people look at a psychiatrist as some kind of “ATM machine” for medication. What they miss out on is this commitment of the doctor to look out for your health and well-being. The doctor is devoted to you. He knows you. You know him or her. You’ve looked each other in the eye. You can call the doctor any time, day or night if you need help. As the saying goes, “If you can’t call your doctor, you got the wrong doctor.”
It’s the old-fashioned value of commitment.
Often patients will tell me that they appreciate our in-person visit, even if it is only one and it isn’t the first visit, even when they move to visits by phone call or video call. They know they can call me anytime of day or night. They know that I know them and vice versa. There is a commitment here. We have a history together. And I am devoted to their care. If there is an emergency, my secretary will knock on the door of my room and interrupt my visit or call me if I’m on lunch. If it’s after hours, patients can call me on my cell phone number.
Now a person may not ever need that kind of emergency response. But many people have told me it is a great comfort to them to know that that’s my level of commitment to them and their well-being. That knowledge helped them face difficult situations, knowing they would soon see me. We would talk it out and see what we could learn from it, and all of that would make it easier to let go of the bad times and look forward to the good times.
You can get that kind of experience with just online visits. But in my experience, it takes a lot more work by the patient to push themselves to open up, to ask themselves to not hide difficult topics. But it can be done, FYI.