Every so often, Zhou Haisong feels that she is weighed down by negative feelings and depression.
"I'm really frustrated, and don't know what to do sometimes. I don't make any progress on my cases, and I am close to being in self-denial," Zhou told the Global Times in a telephone interview.
Whenever she feels like this, Zhou knows it's time for her to turn to psychiatric experts for help.
But Zhou is not any ordinary patient seeking therapy: she herself is a psychiatrist.
She believes her negative emotions are transferred from people who have come to her for psychiatric help, or "visitors," as the professionals prefer to call them.
Zhou has been working in this field for three years, and believes she has been driven to seek help because of the nature of her job.
Turning to colleagues for help
But who do psychiatrists turn to when they find themselves in need of therapy? Psychiatrists can attend lectures or talk to other professionals in their field to try and solve their problems, according to Ou Yongling, a psychiatry supervisor, who works at a psychological education center under the Beijing Normal University Education Training Center.
Visiting senior psychiatrists is an effective choice, but for Zhou, a supervisor doesn't need to be someone who's more experienced than her.
"In a specific period, as long as this psychiatrist can understand me and tolerate me, he or she would make a perfect supervisor," she told the Global Times.
"I need different 'supervisors' in different stages," said Zhou, adding that some supervisors can be helpful in one stage, but not in the next.
Psychiatrists can find their supervisors by visiting them after a lecture or being introduced by colleagues. "When you really need a supervisor, someone will be there," said Zhou.
Lin Ye (pseudonym), 40, has been a psychiatrist for over 10 years and offers advice to both ordinary visitors and colleagues. Some of his visitors are students at a major university in Beijing.
"Trying to be less exposed or not exposed to the public is a requirement for this job," said Lin, explaining that too much exposure could have a negative impact on the relationship between psychiatrists and visitors.
For Lin, every psychiatrist needs to be supervised by other professionals.
"A psychiatrist's job is quite subjective, and sometimes when we talk to visitors, another psychiatrist must be present. This psychiatrist plays the role of supervisor, and his level is irrelevant. This is quite necessary," explained Lin to the Global Times.
However, experienced psychiatrists can offer more suggestions to novices than their peers, he added.
In their job, psychiatrists need a great deal of experience to help visitors with serious problems, while currently in China, most professionals have only been in the job for a short time, said Ou.
When they come across difficult problems, psychiatrists must turn to supervisors for help. But the number of experienced supervisors is limited, and the cost is very high, said Ou.
Commonly, a small team of eight to 10 psychiatrists is set up to counsel fellow professionals in need of help. They share experiences based on previous cases and offer suggestions to each other.
Bigger classes are also held, where psychiatrists attend training sessions for a whole day. In the morning, experienced supervisors share knowledge of psychotherapy and in the afternoon they discuss cases.
"This helps solve the predicament of not having enough supervisors," said Ou.
Where problems arise
Common symptoms experienced by psychiatrists are depression or feelings of rage. Zhou Haisong says this is because psychiatrists use themselves as a tool to work, talk with visitors, analyze their problems, and finally solve them.
"There are no techniques or academic schools that are there for us to use when we deal with specific cases. We only have ourselves," said Zhou.
In order to cure visitors, an emotional relationship first needs to be built between psychiatrists and visitors. After that, trust can be established, and visitors will then practice the proper form of communication between psychiatrists and themselves, which visitors use with colleagues, family members or friends. This is how empathy occurs, and is essential for psychotherapy.
"The form visitors take usually has problems, and it's why visitors need help from psychiatrists," explained Ou.
Under most circumstances, the form of communication which visitors use gets them into various kinds of conflict. They are either mocked or even verbally abused in daily life. But in the therapy room a psychiatrist must try to stand with the visitors and tolerate their defensive tendency or even verbal abuse.
"This is partly where psychiatrists' negative emotions come from," she said.
After a period of time, psychiatrists analyze what's wrong with visitors, and gradually lead them onto a healthy path.
"But the precondition is that psychiatrists should be tolerant and able to control the situation," said Ou.
However, when they come face to face with these visitors, some psychiatrists feel helpless, and that's when the transference of negative emotions occurs.
Psychiatrists may become impatient, intolerant, and even argue with visitors. "The obvious symptom is that psychiatrists don't want their visitors to come any more, even though they won't say this out loud," said Ou, adding that this marks the end of the relationship.
An accumulation of failed experiences will also lead to psychiatrists becoming exhausted. "They feel they have lost the ability to care about others, and they feel 'burnt out' in their career," she said.
The breakup of a psychiatrist-visitor relationship is a form of failure, but is an inevitable one for most psychiatrists. Being too emotional toward visitors is also seen as a failure, because it does nothing to help solve or even detect a visitor's problems.
Besides these failures, psychiatrists also develop their professional abilities through repeated practice and their own observations. They also need to study constantly to improve their professional abilities.
Psychiatrists' confidence can also be undermined by people who don't believe visiting them will work, or conversely, who think that psychiatrists can help solve all their problems, said Ou.
In the end, only visitors themselves can fully solve their problems, and the same is true for psychiatrists, she added.
Being tolerant, both to visitors and to themselves, is an essential quality for psychiatrists. A good psychiatrist won't give visitors the impression he knows everything and can solve every difficulty.
"Acknowledging they don't know something, frankly and naturally, works much better than knowing all and is beneficial to visitors," said Ou.
Value of experience
Lin calls himself a psychiatric supervisor, but admits that he is not recognized as one according to the newly released Mental Health Law, since he does not meet certain criteria.
Under the law, psychiatrist supervisors can only become certified after meeting certain standards which list clearly how many cases they have had as supervisors to other psychiatrists, how many hours of training they have received, and how many times they themselves have been supervised by others.
Besides "curing" visitors, psychiatrists need to further study and carry out research. They also need to constantly work with each other to obtain a deeper understanding of themselves, which is essential to developing their abilities.
"When it comes to handling individual cases, it's what we've realized through talking to each other that helps us work," Zhou said, adding that she does this once a week.
She also attends three academic groups every week. In one group, psychiatrists with the same level of experience work as supervisors for each other.
During the process of being supervised, the relationship between psychiatrist and visitor is presented very clearly, which then helps psychiatrists come to understand the problems they may have in dealing with their visitors, according to Zhou.
Psychiatrists visiting other psychiatrists as patients and discharging negative emotions are both part of the healing process, according to Lin.
He said a psychiatrist needs about 500 to 1,000 such sessions before he reaches the highest level. "The frequency of this experience differs among different psychology schools. Typically, psychiatrists have this kind of session once a week," said Lin, adding that some practice as many as four times a week.
He holds the opinion that any qualified psychiatrist can serve as a supervisor for other psychiatrists, but he emphasizes that this is just his opinion.
"A supervisor is someone who offers suggestions. He lends his feelings to other psychiatrists and helps them analyze cases," said Lin.
A bright future
Both Ou and Lin think that there is much room for the industry to develop in China.
Health insurance in some countries covers the costs of visiting psychiatrists, but this is not the case in China. "Only when health insurance covers this field will the industry develop normally, and psychiatrists can have a stable income," he proposed.
Lin believes that as the economy continues its rapid development, people will pay more attention to their mental health. By that stage, people will talk to psychiatrists before they start to suffer serious mental problems. "This gives an opportunity to psychiatrists, and also for psychiatric supervisors," he said.
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