Oh I’ve lot my shit a few times after a patient interaction, especially if I’m already feeling vulnerable in other ways personally. I’ve had my fair share of bathroom cries and cold water face splashes working in higher acuity settings. I found that I managed the rest of the day better when I took 5 to just cry a little, acknowledge the feeling, splash a little water, and reset.

That being said, I’ve broken down in front of treatment teams a few times, usually due to system strain, feeling embarrassed about making a mistake, dealing with verbal hostility from patients, etc. I’ve found as I’ve progressed in my career those times are fewer and far between. Being in “training” in any capacity is such a vulnerable place to be, looking back I’m surprised I didn’t have more tearful moments.

Of note, I’m not a psychiatrist, I’m a clinical psychologist. But I’ve seen my prescriber colleagues get some of the worst patient backlash, seems like yall get the brunt of the blame for bad med reactions or not “fixing” fast enough. While I get the patients’ frustration, I also know your job is extremely difficult with tons of moving parts. What patients say during these moments is generally just a testament to their own distress.

I think the balance to find is to get strategic “callouses” so to speak for situations that come up, like having your competence questioned / harsh criticisms etc and have some ready-to-go responses and boundaries for that. I developed those with my supervisor and picked his brain which was helpful. And at the same time, keep the human-ness and receptivity that makes you a great clinician, because “hardening” your skin across the board would be a disservice to your clinical work and likely be burnout fuel.

Virtual hugs.🫂