You can call me anytime

In a recent action movie, we see the American actor Mel Gibson featured as a psychiatrist treating a psychopath who escapes FBI house arrest to attend his brother’s funeral, only to have a gang of criminals shooting at him and his family.

The psychopath, who is trying to control his anger and impulses to kill others, keeps calling his psychiatrist for advice while being shot at, and when he decides to leave the house. The psychiatrist, on the other hand, gives him advice to remain calm while sipping glass after glass of wine, then ends the conversation by saying, “You can call me anytime.”

I wasn't sure if the writers of this movie intended to add some comedy to what was supposed to be a thriller, but they certainly got the portrayal of the psychiatrist wrong. Despite our intention of helping people recover,one cannot be available 24/7 to answer patients' inquiries, let alone give advice when the person is being shot at. There's something called therapeutic boundaries that are essential in the doctor-patient relationship. In fact, without such boundaries, the psychiatrist is going to experience burnout, which will damage his own well-being and his relationships with people around him, including his patients and loved ones.

When we talk about burnout, people often visualise an overworked and underpaid worker who gets home exhausted late in the day, only to repeat the cycle the following day. While this can be true, burnout can be experienced differently by people depending on the type of work they are doing and their personality style.

I remember a colleague who became emotionally drained after seeing several patients in his clinic, to the point that he became unavailable for his family once he got home. He basically ran out of compassion toward his wife, who expressed concerns about their son's school performance. He recalled a patient who hurried his long-awaited son just a few hours after the delivery and the intense emotions expressed by that patient.

Having worked in healthcare for the past twenty-eight years, I have come across colleagues from other branches of medicine who experienced burnout, yet they were unable to seek help. I recently read a book by Dr Omar Reda, a psychiatrist of Libyan origin practicing in the US.

In his book, "The Wounded Healer," Dr. Reda explains that there are three main barriers to seeking help. The first is trust, which stops people from sharing their emotions with others for fear of being judged, called weak, or even being removed from certain duties if the person they share with is their manager or a colleague. The other barrier is a feeling of hopelessness and helplessness that nothing can be done if you voice your concerns to top management. Such feelings keep people trapped in their daily routine until they lose passion and stop caring about the people they are supposed to care about. The third barrier is something that men often experience, mainly in Middle Eastern societies, where showing emotions is considered unmanly. That's why we hear phrases like "big boys don’t cry." Only after addressing these barriers can we start dealing with burnout in a positive way.

In my opinion, a good therapist would not say, "Call me anytime," but rather, "Come and see me during your appointment, and if you need emergency care, here are the names of emergency departments you can attend."