Psychiatric slang...

[reallynowriter]

I'm doing research on how Brits would refer to the medical professionals who provide psychiatric care. In the US, if you need talk therapy, you would generally visit a psychologist (or perhaps a social worker, or licensed family therapist, or something similar); if you need extensive pharmacological help (such as prescriptions for multiple psychiatric medications) you would visit a psychiatrist (a medical doctor). You generally (there are exceptions) wouldn't spend hours and hours just talking with a psychiatrist because their time is so expensive. Either one could be called by the slang term "shrink," as long as you were among people who weren't too sensitive to the informality of that word. I am generalizing somewhat here, and know that many variations in types of care and care providers are possible, but for the most part I believe this describes the way things work in the US.

So, would Brits see the same types of medical folks for the same types of care? Would the national health service determine when you get sent to one kind of practitioner or another? And would Brits informally use the word "shrink," or is there some other slang they might use instead?

I hope someone out there knows what I'm talking about and can answer my questions. Thanks for your help!

[SepticTone]

I think this is slightly off-topic for this particular thread, reallynowriter, being basically medical/sociopolitical in nature, but essentially......

"Shrink"= an Americanism, quite derogatory, dismissive & vague, but it is used here in the UK among certain user-groups, usually drug addicts, Woody Allen or Michael Jackson.

Th NHS is a "Free at the Point of Delivery" universal Health Care System, available to every British Citizen, regardless of income, severity of illness or circumstance, & has been here for 60 years. There is also here a small Private Health Care sector, based on an insurance scheme payable by those who wish it, but it accounts for less than 5% of medical treatments, usually non-urgent & fairly simple treatments, like simple hip replacements or basic easy surgery for those who are too busy to go on a short waiting list.

Any & all psychological/psychiatric/pharmacological treatment is available, & is the best in the world. Bar none, except possibly the Cubans... LOL.Over 1.5 million people here work within the NHS, in a working population of 35 million. The NHS is the World's second largest employer, after the Chinese Red Army. Among them quite a lot of 'shrinks'.

So if you think you're crazy, you go visit your GP. They then refer you on to a specialist. If that specialist thinks he's unsuitable, you're referred to a more suitable specialist, etc, until you get fixed. Or not, depending on your degree of psychiatric problem.

The very implication that we can't get access, free & immediately, to the best of any medical or psychological treatment known to mankind is frankly ludicrous. By comparison to the U.S. we're about 100 years ahead of you.

Any form of medical or psychiatric treatment available free on the NHS, I would offer, far surpasses anything available in the U.S., apart from the 'Small Islands of Excellence floating in a Sea of Mediocrity' which characterises the lamentable current U.S. Healthcare system. This goes for much of Western Europe, also.

Oh, & the NHS also covers us free for any treatment elsewhere in mainland Europe, under reciprocal agreements within the EU.

So. Yes. We're covered. & I don't work for the NHS. One's (free) GP is only determined by where you live within a 3 mile radius, & they're the portal to further specialist help.

Check this if you need any more info:

http://www.nhs.uk/Pages/HomePage.aspx

[reallynowriter]

Thanks for your post, SepticTone. I'm sorry if I perhaps didn't make clear exactly what my question was--it was not about who has access to care, or to what care, or at what cost, or anything like that. It really was more a language question, because I just need to know what words Brits would use to refer to the type of doctors they'd likely be seeing for psychological issues. I'm an American who is fortunate enough to have good (employer-provided) health care but who also would very much like for our country to have a system more like yours. I agree that your system provides extremely high-quality care to everyone in an admirably egalitarian and efficient manner. I didn't in any way mean to suggest that anyone would not get every bit of psychological care they required in Britain; I just wanted to know if I was using the right terms for the docs people would be most likely to visit for certain types of problems. I am sensitive, for example, to the danger of confusing the terms "psychologist" and "psychiatrist" and want to use the correct one for the piece (of fiction) I'm writing.

In the US, and I assume in most countries, it really wouldn't (in most cases) be the most efficient thing to send someone who needs weeks or months of regular "talk" therapy to a psychiatrist; there are other doctors with training more suited to that, and that training doesn't necessarily need to include medical school. But if a psychiatrist is what you need, of course that's where you should be sent.

Also the person I've known who was most comfortable using the term "shrink" was in fact one himself (and a psychologist, not a psychiatrist)! So I'm considering using the word, in a very informal, slightly self-deprecating manner (for the character using it), but wanted to make sure it would be understood and wouldn't be just horrifically insulting to a Brit.

Thanks for any other input you and other forum members can provide!

[SepticTone]

Your point is well taken, reallynowriter.
In short, yes... 'shrink' would be inappropriate, & 'psychologist'/'psychiatrist' are equally used in the specific contexts of their specialities, as there are 'behavioural psychologists', 'cognitive behavioural psychologists', & so on ad nauseam.

Linguistically & semiologically, if you're talking to a Brit, then 'shrink' has basically negative overtones, a la Woody Allen, I think, but I'm no expert, but I'd much prefer to be told by a friend that I needed to see a behavioural psychologist than a shrink. But it's not horrific, just a bit 1960's. You've got me worried now.

Psychiatrist always gives me an image of a bearded chap in a frock coat leaning over me while I'm on a rubber couch smelling of ether asking me about my mother.

Self deprecation is a quintessentially British trait, so in the context you suggest, I think it's appropriate & would be taken the right way.

***Edit***

Having mulled over what you originally posted, & subsequent response, it strikes me that there isn't another commonly-used colloquial term for psychological/psychiatric help, as the vast majority of British (or at least English, as that's all I can speak for) people would not dream of even mentioning they needed mental health assistance to Anyone except their GP, nor discuss it with anyone else apart from close family. It would be dealt with as appropriate, but we don't tend to 'wear our heart on our sleeve' nor express extreme emotion or problems openly to the extent that Americans do, as a national trait. Something to do with our myth of 'resilience' possibly. So the language hasn't expanded to include any more colloquialisms or synonyms.

It'd probably be better if we did, but at the moment, that's how it goes as I see it.

[reallynowriter]

Thanks for your help, SepticTone. I think I'll stick with my use of the term "psychologist" as planned, and have the character say, "shrink" at least once in a context where he's deliberately being provocative and self-critical.

It is possible that Americans are as a whole much looser than Brits about being willing to discuss mental health issues. It's still a sensitive topic, but not absolutely verboten.

Your mental image of a "shrink" is amusing, but you may find my real image of one even funnier: picture an older, bearded man in red flannel shirt, blue jeans and suspenders. Also he was one of those men for whom the word "avuncular" was invented. I have no idea how this visual plays into the Brit-culture-influenced imagination, but even in the US, where the backwoodsman look is acceptable, it's a little eccentric. This fellow was, however, probably the best of all the "shrinks" I have ever known (which is quite a few, over the years, in various capacities).

Anyway, thanks for your help! I also welcome any additional comments from you and others, of course.

[SepticTone]

You're more than welcome for any limited help I may have been, reallynowriter.

This page might be of further help re. your question on the structure of psychiatric health provision here & further elucidate my response regarding the perception of mental health issues here in the little embedded video on there.

http://www.nhs.uk/conditions/psychiatry ... ition.aspx

Press the 'T' button on the vid to turn off the subtitles, unless you have severe problems understanding British accents!

But, reverting to the original topic heading of this thread, 'Language differences', this made me laugh:

an older, bearded man in red flannel shirt, blue jeans and suspenders.

I know what you mean, but here we call them 'braces', not suspenders.

Suspenders are what ladies wear dangling off a suspender belt, to hold up their silk stockings.

The image of a psychiatrist wearing shirt, jeans & a suspender belt standing over me'd have me looking at my watch, making my excuses and leaving very very quickly.

[reallynowriter]

Oh, my. I'd never have thought to ask about this! Though I do know the term "braces" (which some in the US use also), it would never have occurred to me to ask just what "suspenders" might be to you...
I think this conversation proves the usefulness of this forum in several ways.

We would call your suspender belt a garter belt, and I guess the suspenders would be garters, though I don't remember ever referring to them (the little snappy things that hooked the stockings to the belt) by name. I remember my mother wearing such things but fortunately for me I am of the pantyhose era (and I can only guess what Brits might call them). Perhaps even more fortunately we are now in an era when I can avoid them all as much as possible, frankly, and stick with socks.

Fortunately, as well, my psychologist character will be wearing neither braces nor suspenders nor garters (though possibly pantyhose), and in fact will never even appear onstage, so to speak. She will only be talked about, and behind her back, no less.

I will look at that last link you sent, too. Thanks for your help!

[SepticTone]

I think they invented garters before suspenders, as here a garter is basically a frilly wide elastic band designed to hold up one's stockings (so I'm reliably informed), before some cleverdick invented suspenders & most men stopped wearing silk thigh-high stockings.

I deliberately exclude Eddie Izzard from this definition.

We still have Knights of the Garter here. They wouldn't be held in quite the same esteem if they were called 'Knights of the Suspender Belt', I suspect.

'Pantyhose' is 'Tights' here, btw. & I also am from that era, & can attest, as a teenage male in the early 1970's, that whoever invented those things wants shooting.

[davec]

American soldiers used pantyhose as currency when dating ladies (both amateurs and professionals) abroad during WWII and later, as well as chocolate and cigs, as nylon was invented here by DuPont, though not with pantyhose in mind.

You failed to specify your grouse, ST. Take too long to pull off? Not available in your size ?

Fool men into thinking women's legs are shapelier than they are? Well, that's a plus when you're out shopping and sober. When you've got her home and you're both buzzed, who cares?

Obviously you don't rob banks, or do Eddie Izzard impressions at the local comedy club on amateur night.

And (so I'm told, or would have you believe), they really help in a pinch for a bondage assignation (think The Crying Game for a really oblique example).

Some women hate them because, when they really let one go, their ankles bulge.

Some men hate them because adult toy stores don't sell an edible variety.

My, I seem to be in a feisty mood today, don't I? Must be spring fever, or maybe Volcano Dust Fever.

Have I opened a can of worms here? In Septic's Companion fashion, we've wandered off psychiatric slang and into couture. I must've been in the wrong lane at the Stairfoot Rarndabart (see thread in the Everything Else category).

My apologies to notreallyawriter if I've carried this thread too far astray. Being a Yank, I can't comment on the original topic. As always, I'll take my ticking off if it's due. Mea maxima culpa, 'n' stufflikethatthere. Otherwise, enjoy!

[SepticTone]

You were clearly drunk when you wrote that, david. But I don't care.

I'll not specify my particular grouse about womens' tights, just leave it to your fervid imagination.

American soldiers stationed in the UK used to bribe English girls with silk stockings, not pantyhose, as this demonic garment wasn't invented until 1959, nylon having been invented in 1938, one year before the onset of WW2, so largely unavailable. ( Sorry, for the late joiners, 3 years before the onset of WW2).

English girls don't need much bribing, frankly, from personal experience.

The fact that all the eligible British guys were away being killed in the war elsewhere in the world for three years may well have led to the girls having to settle for the next best male human alternative briefly shipped in from overseas. See paragraph above.

I note the inventor of tights is now dead. Good.