A patient enters the OPD quietly. They avoid eye contact, sit at the edge of the chair, and answer every question with a hesitant “yes” or “no.” As postgraduate residents, many of us initially focus on symptom checklists and diagnostic criteria. “Sleep?” “Appetite?” “Suicidal thoughts?”
The interview moves on. The checklist is completed. But the patient remains emotionally distant.
Now imagine something different.
“You seem uncomfortable today. Take your time. We can go slowly.”
The patient looks up for the first time.
That moment — small, almost invisible — is often where psychiatry truly begins. Over time, however, we realise that patients often begin to improve from the moment they feel genuinely heard.
Psychiatry is one of the few branches of medicine where the doctor themselves become part of the treatment. Before medications work, before psychotherapy begins, before investigations are interpreted, the patient asks an unspoken question:
“Can I trust you with my mind?”
The answer lies in empathy and rapport.
What is empathy?
Empathy is not simply “being nice” or feeling sorry for someone. It is the ability to understand another person’s emotional experience while still maintaining professional clarity
A common misconception is that empathy means becoming emotionally overwhelmed. In reality, genuine empathy fosters connection without compromising boundaries.
When a depressed patient says, “Nobody understands what I’m going through,” an empathic response is not:
“Don’t worry, everything will be fine.”
Instead, it may sound like:
“That sounds exhausting. You’ve been carrying this for a long time.”
One response dismisses suffering unintentionally. The other validates it.
Validation does not mean agreeing with every belief or behaviour. It means acknowledging that the patient’s emotions are real and meaningful.
The challenge for young doctors
Empathy is easy to talk about and difficult to sustain.
Long duties, academic pressure, overcrowded OPDs, emotional burnout, and repeated exposure to suffering can gradually make young doctors emotionally detached. Some students begin to see empathy as “extra work” rather than a clinical skill.
But patients remember how doctors made them feel long after they forget prescriptions.
A senior psychiatrist once said:
“Patients may not remember your diagnosis, but they will remember whether they felt safe with you.”
That statement captures the heart of psychiatry.
Dr. Nishtha Chaurasia
Senior Resident
Department of Psychiatry
AIIMS Bhopal
