Psychiatry is more difficult than I expected, though not for the reasons I had expected. I had worried about being depressed and over-identifying with the patients as I did when I was a medical student. Perhaps it is with more life experience, or perhaps the fact that all my patients are teenagers, but this does not seem to be a problem so far. I still identify very strongly with the patients (as is appropriate for a paediatrician) but now I am able to keep myself a little apart and see their problems as, well, their problems. This lets me identify where their behaviour is adaptive and where it is not.
The problem seems to be with the parents. Perhaps it is this strong identification with the patients, or seeing where the parents own behaviour is not adaptive, but I find myself increasingly blaming the parents and getting frustrated with them. I see that this is not an adaptive response for me! Doing something about it is much harder, though...
As Michael G pointed out in his orientation lecture on that first day - sometimes the inability of the system to change or to accept help and suggestions is part of the problem. This is till their problem, not yours. While true, this only allys my anxiety partially. On Friday morning I didn't want to come to work and see three patients, which I recognize in myself as non-adaptive avoidant behaviour. Maybe that doctor/patient separation is not as complete as I thought!
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