Make Fun of my Job and I’ll Stab You

Dr. Rob,

I’m a sophomore in college and I need to start thinking about my future. I’m pretty sure I want to be in mental health. What is the difference between a Psychologist and Psychiatrist, and what are the benefits of choosing one over the other as a career?

Nicole


While psychology is one of the most popular majors in United States colleges and universities, few go on to actually practice in the field due to the extensive graduate work, so it’s great to hear about a future colleague preparing to enter the fold. The differences between psychiatrists and psychologists are vast and important in terms of both training and practice. Psychiatrists are physicians. They complete the traditional medical school training and then study the specialty of mental health, generally from the medical perspective. In large cities like New York, many psychiatrists do also practice psychotherapy (especially Freudian-type psychoanalysis), but over the years more and more psychiatrists have tended to handle solely the medical management of mental health (i.e., drugs).

Clinical Psychologists attend graduate school, as opposed to medical school, studying mental health from a psychological perspective, rather than a medical one. While psychologists are given basic training in medication and anatomy/physiology, their focus is generally on therapy rather than medication. Psychologists also do the majority of psychological testing to address issues such as ADHD, I.Q. scores, learning disabilities and the like.

Broadly speaking, psychiatrists make more money than psychologists. In private practice, psychiatrists complete medication management sessions in approximately 15-20 minutes, whereas a therapy appointment with a psychologist is 45-50 minutes. Over the course of the day then, psychiatrists are generally seeing more people. They also tend to garner more respect from the community because of the fact that they are physicians and can provide you with medication should you need it (there are only a few states that allow psychologists to do this). However, I am told that psychiatrists are at the bottom of the food chain of physicians. Weight loss surgeon Dr. James weighs in:

Don’t even get me started. Psychiatry is the easiest residency in the world to get into, no one in the medical field respects them, and if a patient needed help with anything like a broken arm or sore throat, a psychiatrist would be completely clueless as to what to do. And they are so damn weird! You ever notice that? Psychiatrists are possibly the strangest people on the planet, analyzing everything you say, with hardly any social skills. And they are supposed to be knowledgeable about what is “normal?” Please. They need to know how silly they look to their peers.

Psychologists, while not prescription writers, can often get a great deal of credit for not looking to provide the “quick fix” and by not throwing a pill at a problem. This is vital to a large portion of the population that is hesitant to take medication for mental health problems. A psychologist’s non-medical position can sometimes help clients be open to understanding themselves fully and to exploring how they’ve arrived at this juncture in their lives. However, because psychologists often don’t get the same respect as our medical colleagues do, many of them have inferiority complexes. A great example of this is our socially phobic psychologist Dr. Pete who is more than happy to chime in, having recently emerged from hiding in a bush so that he didn’t have to talk to the mailman:

Most of us [psychologists] go to school for at least six years after college, focusing solely on mental health. I know medical doctors go to school just as long, even longer, but so much of it is spent dissecting cadavers and reading about endocrinology, things that they not only forget, but have no use for in the field. We’re the real experts on mental health! Rob, you’re not going to print this, are you? My psychiatrist would be furious if she knew I said these things about her field.

In college, I knew that I wanted to be in mental health, but was unsure which direction (psychology or psychiatry) I wanted to go. I wasn’t very good at hard science, struggling in biology, chemistry and physics. I also knew that medicine couldn’t solve everything, regardless of what the makers of Prozac wanted us to believe, and thought that I would enjoy being a therapist much more. However, I wanted to have the highest level of education in the field of psychology as possible, so I decided to basically throw away my 20’s to get a doctorate in the field and claim my “fake doctor” status. Every once in a while I’ll look back and think that it might be nice to have a medical education, but certain events remind me why I made the right choice:

When I was in graduate school and told people that I was studying to become a psychologist, I tended to see an expression that was a mix of skepticism, apprehension, and maybe even disdain. I’m sure that my age and baby-face made it difficult for people to believe that I could be a person possessing any form of wisdom or helping ability. And of course there are people who see the treatment of psychological problems as sheer quackery, especially if there is no prescription to write, so these responses made sense to me. However, after a few years of successful practice and a couple of gray hairs on my head, I assumed that my job title would afford me at least a certain amount of respect from the general community.

I recently attended a wine tasting/social hour, arranged through a local gathering website. “Why You Need Not Fear Bordeaux” was the theme (because, as we all know, Bordeaux is clearly the most intimidating of red liquids that you consume for recreation), hosted by a local sommelier in a downtown loft. Most of the guests in attendance were somewhat older than me, 40’s and 50’s mainly, and clearly much more well-to-do. Wall Street gurus, plastic surgeons, successful artists were all on hand, wearing Armani and Prada, despite the fact that the flier clearly stated “Casual is fine, I’ll love you anyway!” Because love is important to me, I wore jeans and a rugby shirt, both courtesy of The Gap (20% off with coupon).

After chatting with a successful architect for about 15 minutes (i.e., hearing about how awesome he was at basically everything), he asked me what I did for “work or trade,” like I could be a plumber who was there to unclog the toilet in my rags that I tried to pass off as clothes.

“I’m a psychologist.”

He sort of scoffed/chortled at this. “Oh you are? So if I tell you I’m depressed, which I’m not because I have everything in the world going for me, are you going to write me a prescription for Zoloft or something?”

“No, that’s what a Psychiatrist does. I’m a Psychologist.”

“So what is it you do then, exactly?”

I began to explain all of the nuances but I got the impression that I was boring him. This astute observation was due to a combination of him staring at his watch, the plasma television, the hostess’s butt, his cigarette ash, the smoke from said cigarette, his tie, and his hair in the mirror behind me.

“Right. A lot of people think that stuff is such horse shit. So you just talk to people to help them feel better about mental stuff?”

I began to point out that his take was a bit of an oversimplification, but he wasn’t done yet.

“Are you successful?”

“Excuse me?”

“Are you successful? As a psychologist?”

“I guess that depends on how you define success” I said.

“Are you wealthy?”

“No.”

“Do you have a booming practice?”

“Booming? No.”

“Can you charge above your market’s rate and still get clients?”

“Probably not, no.”

“Do ladies want you because of your job?”

“Well, I did have a woman tell me that I seem very nice and kind, and that that was probably because I’m a therapist.”

“So no then?”

“Right.”

“You’re nothing like me,” he said, obviously pleased with his interrogation. “I’m successful: wealthy, good-looking, with as much female companionship as I want. I design glorious homes for people of extensive means and I make their lives better for it.”

“Actually,” I countered, “I’m a lot like you then. Sometimes, although not always, I can help a person get rid of intense psychological pain. Pain that they never could have imagined. I’ve had wealthy clients tell me that they’d rather give up all of the fortune and material possessions to not feel like they do right then. And when I help them, I make their lives better, just like you do.”

“Whatever,” he said, clearly unconvinced. “Right now you’re just some guy with a lot of education who talks to people for a living. A quack, basically. You’d be a lot more successful as a psychiatrist, because then you’d have a prescription pad and could fix a lot more problems.”

“I don’t know about that.”

“How do you figure?”

“Well, if I were a psychiatrist, there’s nothing I could write that would stop you from being a narcissistic prick. You’ll probably need years of therapy to not be the pretentious and elitist asshole that you are. Here, take my card. I can fit you in next Wednesday. And bring some of your cute little drawings of houses. We can compare them to the ones I did in kindergarten. We can’t have enough mansions in the world now, can we?”

Surprisingly, he actually took the card, mumbled something about me being a peasant, and walked away. A few moments later, I was told by the hostess that I was no longer welcome at the wine tasting sessions due to my “coarse language and disregard for the city’s high end urban development plan.” I left, but was able to get a few more sips of some really expensive Bordeaux before walking out.

And just think: it only took ten years of post-high school education to diagnose that man in less than 20 minutes. It was totally worth it.

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39 Responses to “Make Fun of my Job and I’ll Stab You”

  1. Charles says:

    Haha, wow, that makes me so happy I don’t live in a city that is so success oriented. I couldn’t imagine going to a party with people lining up pecking orders. Sounds like he had the inferiority complex though as he had to prove that he was a better person by measurable means. Even to go as far as a prescripted series of questions to find something wrong is just sad.
    Great story!

  2. TenPercenter says:

    That was a quality payoff.

  3. Amber says:

    That was great! I wish I had some kind of credentials behind me when I rightfully tell an asshole what I see in him/her.

  4. Straw says:

    Wow, I guess the next time I have a broken arm or sore throat I better not go to a psychiatrist!

  5. G_Man says:

    The guy you talked to sounds like John Fitzgerald’s older brother.

  6. Blank says:

    That was hilarious. I’m so glad that you stood up for yourself and called the bullshit he was selling.

  7. Ben says:

    Wow Dr.Rob, that was a great post. I hate pretentious assholes, I am thinking about taking psych as a minor but I am awful at statistics.

  8. Julene says:

    I feel as if your response should’ve been part of the “priceless” campaign MasterCard had for a while there.

  9. J says:

    Just remember that the Ph.D. is the highest degree you can earn at a U.S. institution. Our medical students groan at graduation every year when that fact is stressed and the Ph.D.s are the last to be honored…

  10. Ploin says:

    wow, the guy was over the top arrogant. What a douche, good thing you call him out on it.

  11. Maggy says:

    Thank-you for putting that douchebag in his place. And fuck silly aristocratic wine gatherings.

  12. Craig says:

    I was going “eh, what’s the point” for most of this… at the end, I got a nice chortle in. Thanks for brightening up my evening!

  13. Luba says:

    I deff appreciated that post. As a college student studying to get my bachlors in a primarly business school, you get a lot of weird looks and questions like Why dont you just do finance? I think its funny how people underestimate the field, yet they are probably the first to develop some kind of anxiety/depression if not already possesing some kind of personality disorder… as you pointed out!! to get through college, I’m waitressing in a very haughty toitty lounge in nyc. esp. there you get this shit from people everyday!!

  14. :yb detsoP says:

    hahaha!

  15. Crab says:

    Wow, reading that I must say I was surprised. If anything, I’d have said that people would generally respect therapists much more than psychiatrists – maybe it’s a different view this side of the pond, or just the people I know.

  16. Wayland says:

    Rob, you’re a rock star to me right now. That guy’s attitude was his “20%-off coupon” for the mental a**whooping you gave him. That was great. I’m proud of you bro!
    Dr. Rob Note: Thanks so much for the praise! However, if you saw me pick up an instrument (or even do my real job perhaps), you might change your mind about my rock star status…

  17. DannyMac says:

    Total inferiority complex. My wife is an architect and there is no more reviled creature in the architecture community than wealthy residential architects.
    Now that’s mostly just jealousy since so many architects are terrible business people and it’s a completely flooded industry, but trust me that guy has more professional doubt that most everybody on this site put together.

  18. DocD says:

    That is a great story Doctor Rob. Although I am only a physcian in training, I hope to someday be able to read patients the way you read people. Just remember, that night could have been worse. you could have talked to the surgeon…
    Andy

  19. Stereotypical Post-Grad says:

    Wishing I were still a sophomore in college, I am now a recent college graduate with a BA in Psychology. Great for me, huh? I think the only more useless degree is an English major. After a single-minded dedication to the field of mental health, being convinced of nothing more than that I wanted to go into therapy, I applied to grad school, was summarily rejected, and am now in the throes of early-20s existential angst. Actually, one of the only things keeping me going right now and helping me allow myself to still consider psychology as a career is your blog. It’s comforting to know that therapists are (imperfect) people, too.
    Anyway, I have a few questions for you. As someone in the field, 1) what is the difference between a Clinical PhD and a Counseling PhD, 2) how much or how little respect does a PsyD get (outside of academia, obviously), and 3) which degree do you have?

  20. kate says:

    Stereotypical Post-Grad: don’t feel bad about getting rejected. clinical psych phd programs expect applicants to have a year of research experience, a year of clinical experience with mental health patients, significant volunteer experience and solid references from professors and researchers who know your academic work in detail (not to mention the GRE and GPA cutoffs). I have a majority of these (minus the GRE math)as well as 3 years of master’s work, psi chi leadership, teaching experience and many more things that would inflate my ego if i posted them on here, and I’m seriously doubting whether or not I can get in anywhere.
    Here’s a link explaining the PhD/PsyD stuff:
    http://www.psichi.org/pubs/articles/article_171.asp
    Some Psyd’s are more research-oriented than clinical Phd’s. PhD’s in Counseling are easier to get into but you have to pay a lot more. You can also check out the Master’s in Counseling (depending on what state you’re in), but personally I think people who get those are ill-prepared to be counselors. Most importantly, while I’m tempted to tell you that yes, your degree is totally worthless, it’s not. Depending on where you live you can use your degree to get a job as a research assistant (for example at the Psych Institute in New York), which will make you look solid as an applicant next time you apply.
    Good luck, and please don’t apply this year because I don’t need any more competition!

  21. Scott says:

    While I certainly appreciated the story (Sophomore Psychology major here) I do have to wonder about the accuracies of this particular… exchange. Personally I wish I were that witty on the spot, though more often than not I have to admit my responses aren’t quite as… sharp. So I have to wonder if perhaps you bloated your own position in this exchange. Oh, and also, never in my life have I come across such a stereotypical prick… Regardless, I thank you for an entertaining tale!

  22. mo says:

    While I’m certainly no big fan of health professionals I have to admit that was a great post. Nice one!

  23. SingleGirl says:

    I’m a therapist (clinical social worker) who is smack dab in the middle of deciding to go on for a doctorate in clinical psych… posts like these SCARE me.
    Your story at the end about the asshole @ the wine tasting… Does it not ever bother you that it’s so easy to compartmentalize people based upon their DSM symptoms?
    I am uber-tolerant and accepting… but dating since I began working in this field is TORTURE! Ignorance is bliss… but when red flags are constantly popping up, I go all clinical crazy and am not nearly as accepting or forgiving as I used to be of people’s normal human experience.
    Plus, when I date control freak assholes, their FIRST argument always start with… “go ahead, why don’t you just go ahead and diagnose me, I know you want to anyway.”
    So, I came to this site today to make sure you weren’t bustin’ privacy laws and ethics to hell (but kinda hopin’ you were)… and I found myself really triggered by what I read. DR. ROB NOTE: PLEASE PLEASE READ DISCLAIMER!
    I want my doctorate b/c my area needs more doctoral level clinicians and I know I’m skilled enough to succeed… sort of public service… but the thought of spending the rest of my life with spidey senses directed @ personality disorders and addictions… it’s scarier than a dissertation.
    Be well and thanks for listening, I’m going to email this to you as well, I want you to know that you broke my brain this afternoon.

  24. Joel I says:

    Thank you for this insight. I’ve decided as a result of your confrontation with this man and all that you’ve said of psychiatrists has helped me to decide that I rather be a psychologist. I’m still in high school, but still, I know have reassurance in that psychologists can maintain their dignity among “more” successful people.

  25. Stephanie says:

    I like your site. Anything psychological is inherently fascinating to me, and to most people, I’ve discovered. You’re a strong writer and I appreciate your 98% grammar and spelling accuracy. I also appreciate all the hard work and studying you’ve put into becoming a psychologist. Your work helps people, and for that you should be proud.
    However. Some constructive criticism:
    *I do understand your need to summarize your holistic experiences and create general stories of them, but because of this, your writing arouses suspicion of its truthfulness and/or accuracy, which is distracting to at least me, if not others.
    *I appreciate your open, sincere expression, but it can come across as downright violent–there are few human body parts I have not yet seen you describe wanting to maim (or that someone else has wanted to maim). I appreciate the creativity, but I, a pacifist, find myself feeling disturbed and violent after reading some of these.
    *Your shifts in tone between self-deprecating and immodest can be erratic and confusing.
    Of course, this is your forum, and I respect your conducting it as you see fit. I wanted to contribute my honest two cents to you.
    All in all, great job on an excellent site that I have recommended to friends!

  26. Avrila says:

    I’m surprised no one beat me to commenting on what Mr. Oh So Successful was obviously compensating for.

  27. a pedant says:

    “Well, if I were a psychiatrist, there’s nothing I could write that wouldn’t stop you from being a narcissistic prick. You’ll probably need years of therapy to not be the pretentious and elitist asshole that you are.”
    I may be wrong but do you mean “…that would stop you from…” Sorry if I missed something and wasted your time with this. Good stuff here. Sending a link to my favorite shrink!

  28. Sue says:

    Thank you for an entertaining and informative post. I have often wondered myself the difference between the two, and learned the hard way that a psychiatrist is only interested in pushing the latest drug on the unsuspecting parent of an ADHD kid.
    It didn’t nothing for my daughter expect give her physical ticks and fainting. It didn’t change the issues… that ADHD was causing unsavory behavior and poor personal habits. I dropped the psychiatrist when he tried, for a third time, to give us a prescription, and then he referred us to a counselor. I realized then that he could not help us.
    Without prescriptions my daughter has thrived. I went to parenting counseling on my own and learned how to better myself as a parent so I could help her, and that worked. Talk therapy worked. Imagine that. 🙂 Again, thank you!

  29. Anonymous says:

    Good for you for putting that asshole in his place
    He’s a coward and a bully and got his comupance. You rock!

  30. (Linked from a newer post)
    I’ve run into guys like that before, typically I avoid the pissing contest, but if pushed I explain a bit of my research or the work I do, and they generally realize I am much smarter than they are, so they tend to shut up. At least you enjoyed the wine!

  31. April says:

    Um, hilarious.

  32. Jenny says:

    I just started what will surely be obsessive research on whether or not I should be a psychologist and have decided upon reading three blog entries that you are my new found hero: A) because I suck at science but hoped that I could be a psychologist anyway B) I fear losing my sense of humor through years of mental health education, but clearly yours is intact. In short, you give me hope.
    Thanks!

  33. Dyson says:

    Kick ass and take names, Dr. Rob! Let’em know us Psycholgy folks won’t just take that kind of abuse.

  34. Adrift says:

    Stephanie, you majored in English didn’t you? I’m just starting out as a psychologist, but you’re showing some traits of Obsessive Compulsive Personality Disorder (I checked, pretty sure OCPD will be in the DSM – V)…

    P.S. Not trying to be hostile, just a friendly jab on the topic of 20 sec diagnoses 😛

  35. Cam says:

    I think the really important part here is that you got to enjoy some tasty Bordeaux (hopefully on someone else’s dime) whilst simultaneously calling out a complete dick. Sounds like a win 😉

  36. Annie says:

    It was hilarious!

  37. Fuma says:

    Great post, very funny.

  38. Chris says:

    So what was your diagnosis exactly? That he was a narcissictic prick? If so I don’t think it requires 10 years of education because it was pretty obvious. Furthermore, I’ve never encountered such an obnoxious and shortsighted person in my life…makes me think this was made up but I do acknowledge that it is possible.

  39. Lee B. says:

    I’ve actually used the line “Make fun of my job and I’ll stab you,” but in my case it makes more sense because I coach fencing. 🙂

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