COMMUNICATION GAP BETWEEN A PATIENT AND PSYCHIATRIST

Prepared for:

Comsats University Islamabad

(Lahore Campus)

Prepared By:

Anna Shafiq (021)

Tasbiha Saleem (017)
Maha Khan (044)
Fatima Tariq (040)
Muhammad Hammad (003)

March 6, 2021
 Table of Contents

Introduction:...............................................................................................................................................3
Communication Barriers:.............................................................................................................................3
Societal Stigma & Obstacles:...................................................................................................................3
RELUCTANCE AND DISCOMFORT:............................................................................................................4
LACK OF FAMILY SUPPORT:.....................................................................................................................4
Gender Differences:.................................................................................................................................5
DUE TO MONEY AND FINANCE:...............................................................................................................6
Introduction:

In order to understand this topic first we need to understand what is communication gap?
Communication gap in general means that when one of the persons out of two does not
understands the meaning of conveyed message in the way as it is being said and conceives the
message wrongly creating a big communication gap in between them.
According to the research conducted by Marie Savanda MD, (2004) 22% of primary care
patients never receive the correct diagnosis and optimal treatment. This problem arises due to
communication gap between patient and psychiatrist.

Communication Barriers:

In present times there is a wide communication gap between a patient dealing with mental illness
such as emotional distress, anxiety, depression or bipolar disorder and a psychiatrist. Some of the
major barriers are stated below:
1. Societal Stigma & Obstacles
2. Reluctance & Discomfort
3. Lack of family support
4. Gender Differences
5. Money & Finance

Societal Stigma & Obstacles:

The stigma associated with mental illness is highly
prevalent in Pakistani society. People with mental
illness are one of the most stigmatized strata of our
society. This stigma causes communication gap
between a patient and psychiatrists.
Societal disapproval and public shame on people who
live with a mental illness discourage the patient to seek
help from the psychiatrist and the respective patient is unable to communicate his problems to
the doctor.
Despite the availability of psychiatric care, individuals often do not seek basic treatment due to
their fear of public humiliation and shame which do not only lead to stress but also become a
huddle to bridge communication gap between a depressed patient and therapist. They are
challenged not only by their illness but also by the stereotypes associated with them by the
community.
Pakistan is a culturally and ethnically diverse country that is home to a number of religious
branches of Islam whose practitioners can nurture very complex belief systems. One of the
examples is to open up to a stranger (na-mahram) is considered forbidden in Islam.

Beliefs in black magic, the evil eye and possession by Jinni (demons) are widespread concepts in
this society that mental health issue is immediately associated with these concepts and it is
encourages to seek help from spiritual leaders in our society rather an a psychiatrist.

To bridge this communication gap and break the stigma it is compulsory to address societal
apathy towards the treatment of mental illnesses and educate the society as well as the
patients to break these societal obstacles.

RELUCTANCE AND DISCOMFORT:

Opening up is hard to do. A patient may think of seeing a psychiatrist but stops himself thinking
that he could never bear someone in a position of authority telling him that he is living his life
wrongly or commenting on something he feels vulnerable about. This is hard when he thinks
about sharing thoughts or information that he may never have revealed to anyone else. This is
undoubtedly a major communication gap between patients and psychiatrist.
Therapy is a place to freely share your feelings even when you are ashamed of them. Patients
feel discomfort in sharing their thoughts because they think that their conversation is not
confidential and their psychiatrist might share information with their family. This causes a
communication gap between patient and psychiatrist.
Patients also make judgment about their psychiatrists and it sometimes cause a communication
gap between them. For example, they think that if a psychiatrist is physically old than he could
be irrelevant, if he is young than he could be immature, if he is charging high than he is greedy.
The thought process prevailed in our society is depicted through this dialogue which is one of the
major issue social stigma: "Therapists don’t say anything; they just sit there and judge you."
The most frequent dialogue we hear around us is "I’d feel weird talking about this stuff to a
stranger."

LACK OF FAMILY SUPPORT:

Talking about your feelings and reveal what’s inside one’s self is already a hard task to
accomplish. We have a certain bond with our family and their support is quite important at
different turn of events in our life. When one feels the need to talk about his troubles it gets very
burdensome.
Acknowledging your own real feelings is a tough job in itself and then comes the pressure from
family. Superstitions are embedded deep inside us and when one starts to speak or share it starts
with black magic and ends with ghosts. Nobody is willing to take you seriously. Sometimes we
just need a push to reach to the top, to decide if we really need psychological help but this type
of comments make you uncertain if it’s really worth a shot.
Then come several members that call you crazy just because you over react on a specific point.
Even if you’re not one the word ‘mad’ will surely make you feel like one. There is also an issue
when parents say what people will think if my child goes to therapy. The perceived social stigma
linked with metal health is a major discouragement to those seeking therapy. They need to
acknowledge the fact that there can be different problems other than being declared crazy. When
all of this is happening around you it’s hard to focus on one’s mental health.

Gender Differences:

Gender differences between patients and physicians have a significant impact on the quality of
communication in treatment processes. It has been shown from studies that communication
between patients and doctors of the same gender is often very satisfying.

It also varies according to the cultural and societal values of any country and region for example
in Pakistan communicating with opposite gender is very weak as people interact less. Gender
differences between patients and their physicians have a significant impact on the quality of
communication interactions in treatment processes, thus ultimately affecting the quality of
treatment patients receive.

Many patients feel awkward when opposite gender doctor analyzes them. They feel awkward to
share their condition to them which influences their treatment cycle. Some patients try to avoid
physical contact with opposite gender doctors by their religious means or shyness; they also get
awkward while sharing their definite condition to a specialist. They don’t get into a comfort zone
with their doctor.

Past trauma or abuse may make some people feel uncomfortable

talking to someone of the same sex as their former abuser. A
woman who has survived domestic violence in a heterosexual
relationship, for example, may not feel comfortable following treatment with a male doctor. It
can be very stressful or arousing, which can reduce the goal of an effective treatment session.

DUE TO MONEY AND FINANCE:

Let’s understand this communication gap in terms of a short story:

Suppose that a person who is suffering through stress that is increased to the extent that he
himself alone cannot resolve for himself as in the present moment he has reached to the high
level of depression and his final way to come out is the doctor. So, he goes to the doctor who has
high fees that he cannot afford but he finds doctor so good that in start for first 2 sessions he
somehow arranges the money for himself for fees.
But for how much long time he could do so! And then finally a situation comes about which we
had talked about at initial stage that is communication gap means where one person could not
send his message properly to the other due to lack of finances.
Psychotherapy is an investment on yourself. Several times the expense is not practical and cost
head off much more life- affecting problems in the future. Consequently, the patient is reluctant
to discuss this issue with the therapist and end up missing the sessions.
Several patients think that "Therapists don’t really care about you; they do it for the money."
This causes communication hindrance.