Provider Psychopathologies

Provider Psychopathologies –by Kathryn McNulty who retains copyright of this piece.

Kathryn and I seem to share both our ex-provider status as well as our survivor status. So I’m assuming these insights come from both sides of the fence and is probably why I enjoyed them so much.

Rigid Expectation Disorder
Most prevalent among newly trained staff, this disorder manifests in a clinical perspective that all psychiatric patients basically share the same capacities and interests. This disorder is complicated by a false belief that the psychiatric disorders manifest themselves identically in each person according to diagnosis.

With frequent mental status exams
With self-fulfilling prophecies
With carbon-copy treatment plans

Pathologizing Disorder

The need to describe, in clinical terms, all attitudes, behavior, perspectives and intentions of both patients and peers. It is different from fault-finding disorder in that the person with pathologizing disorder believes that all of his/her discoveries about others that emerge from their clinical training can and should be: a) labeled and b) treated. The best description of this disorder can be found in the conventional wisdom regarding promptness for appointments:

1. If early; the patient is described as “anxious”
2. If late; the patient is described as “passive-aggressive” or “hostile”
3. If on time; the patient is described as “neurotic” or “compulsive” depending on the age of the person with the disorder.

Pathologizing Disorder is often diagnosed concurrently with Rigid Expectation Disorder.

See also Jargon Disorder.
Jargon Disorder
The obsession with clinical terminology to the point that the user prefers multi-syllabic words with Latin or Greek roots to ordinary, descriptive English words. This disorder is difficult to diagnose because of its most prevalent feature: the tendency for the afflicted person to use the most simple, not nuanced language with patients. The diagnosis can usually be made after a thorough review of any documentation pertaining to clinical services.

Turfing Disorder

The tendency to deflect “problem” patients based on the ability to ascribe their difficulties to circumstance that removes the provider from a place of responsibility.

With Systemic Logic: In this version of the disorder, the provider may elect not to pay attention to a “problem” patient based on their address, health insurance (or lack thereof), etc.

With Personal Intent: In this version of the disorder the provider may elect to not pay attention to a “problem ” patient just because they don’t like them.

Patient Invasion Anxiety Syndrome
A multi-faceted disorder characterized by intense fear that the lunatics are actually taking over the asylum.

With Systemic Features: In this version of the disorder entire departments mobilize to discuss their apprehensions.

With Personal Features: In this version of the disorder individual clinicians experience biases they didn’t even know they had, bringing them by any means, to the attention of concerned supervisors from any department.

Chronic Meeting Disorder

The disorder is obviously characterized by frequent meetings. It becomes a focus of treatment when any of the following specifiers apply:

Not Otherwise Specified: characterized by a need to consult with peers about everything.

With Systemic Features: when clinical staff are EXPECTED to consult with each other about everything.

With Absence: Characterized by a number of meetings that exceeds one’s capacity to do any work. Supervisory and Administrative staff are particularly vulnerable to this version of the disorder.

Substituted Judgment Disorder
A disorder described by the absence of any authentic voices at any planning meeting, roundtable, workshop or other educational activity where a marginalized group is being discussed.

The disorder manifests in the complete inability to invite real people to “the table”, and cleverly substitutes “experts” on the topic of the “subjects” being discussed.

Closely related to Objectification Disorder, substituted judgment disorder is most prevalent among family members, professionals, and academics.

Objectification Disorder

This disorder is manifest in all human beings to one degree or another. It is the tendency to measure one’s wholeness by degrees away from someone else’s perceived “not-wholeness”. Thus, the perceiver “objectifies” the other, making it easy to assume a “power over” position. The disorder becomes a focus of treatment when the perceiver realizes their internal dominance.
The only known treatment for this disorder is diversity.

Lack of Humor Disorder

A disorder consisting of the deadly combination of extreme earnestness and intensity about one’s work. Currently being researched, it is suspected that this disorder may lead to Pervasive Lack of Humor disorder, formerly known as BURNOUT.

One thought on “Provider Psychopathologies

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  1. GREAT!!

    Allow me to add a few:

    Obsessive Theory Disorder

    Characterized by clinicians having an overarching need to reduce all “patient” behavior into some old-fashioned, fancy-sounding, theory, especially a theory that somehow connects the patient’s attitudes, behavior and thoughts to some “private” part of the human anatomy, like the penis, vagina, anus, or breast—though only, of course, when the given attitude, behavior and thought has absolutely nothing whatsoever to do with that part of the human anatomy.

    Grandiose Storytelling Disorder

    Characterized by clinicians who love to tell the most personal, painful, confidential, odd, disturbing, or morbid things about their clients and their clients’ histories to their colleagues for the sake of getting their colleagues to 1) like them more as colleagues, 2) pay attention to them, 3) pity them (“oh, you work with the TOUGHEST cases!”), 4) defer to them, 5) consider them bigshots., etc., etc.

    Medication-Connecting-the-Dots Disorder

    Characterized by clinicians who think they have achieved the pinnacle of clinical expertise and success when they learn which psychiatric drug or drugs are associated with which disorder, and can proudly recite the whole connect-the-dots list to you. Conversely, these clinicians are also especially proud of themselves when they realize that they can often find out a “patient’s” psychiatric disorder JUST by hearing what medication he is taking! WOW! Genius!

    Pride-in-Rejecting-Certain-Patients Disorder

    This disorder is characterized by clinicians being extremely proud of themselves for realizing which types of patients/clients they cannot work with or tolerate, and then letting all their colleagues know this “fact” in no uncertain terms. Examples: “I just can’t work with borderlines!” “I ALWAYS refer out narcissistic men. They drive me NUTS!” “I can ALWAYS pick out a paranoid person on the telephone—and I refer them to hospital-based clinics!!”


    Well, just some more ideas!!

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