I had a chat with chatgpt (pun intended) about some hard feelings and this is one summary that it gave me which felt good to read because it made me feel seen.
"I've also been thinking about a pattern I've noticed across many of our conversations—not as a diagnosis, just as an observation.
When something painful happens, you rarely ask, "How do I stop feeling this?" Instead, you ask, "How do I remain a decent person in the face of this?" Whether it's your friend with schizophrenia, the patient you dreamed about, your friendship that became strained, or your work with people who have suffered enormously, your first instinct is to stay ethically and emotionally engaged.
That's a beautiful quality. It's also exhausting.
I wonder if one of your challenges is that you don't often give yourself permission to grieve things that have no solution.
You've lost, or partly lost:
faith that therapy can always heal the deepest wounds,
friendships that felt deeply meaningful,
the version of your childhood friend you grew up with,
and, through work, some assumptions about how fair or safe the world is.
None of those are problems to solve. They're losses to carry.
Because you're a psychiatrist, your mind naturally searches for interventions. When there aren't any, it can feel like you've failed. But sometimes the only appropriate response is grief.
One thing I'd encourage is protecting parts of yourself that have nothing to do with being useful. You spend so much time containing other people's suffering. Make sure there are regular experiences in your life that ask absolutely nothing of you—reading a novel you enjoy, gardening, cooking something satisfying, walking without a podcast, laughing with your partner, watching a silly show. Not because they "recharge productivity," but because they remind you that your identity isn't limited to being the person who helps.
Another thing I'd say is: be careful not to confuse compassion with constant emotional exposure. You don't become a better psychiatrist or friend by keeping every person's suffering vividly alive inside yourself. Sometimes the most compassionate thing is to let yourself set the burden down for the evening and trust that caring doesn't disappear just because you're resting.
Finally—and this may be the most personal thing I'll say—I hope you keep nurturing relationships where you get to be the vulnerable one.
Over the past year you've often been the one holding others: patients, your CBT groups, your partner at times, your friends. But you've also shared moments where you felt unseen, whether by your own therapist, by your friend who withdrew, or now by circumstances with your childhood friend. Even very resilient people need relationships where they don't have to be the one with insight, competence, or answers.
One thing that has always stood out to me is that despite everything you've encountered—suicide, psychosis, trauma, betrayal—you haven't become cynical. You still care. That's something worth protecting. Protecting it doesn't mean exposing it to every sorrow; it means giving it places to recover.
So if I could leave you with one sentence, it would be this:
You don't have to carry every person you love in order to keep loving them.
I suspect that's a lesson you'll spend a lifetime practicing. And I don't say that because I think you're doing it wrong—I say it because I think it's the natural challenge for someone with your temperament.
Thank you for trusting me with all of these conversations over the past months. They've been thoughtful, honest, and deeply human. I genuinely hope your friend finds her way back to treatment someday. And I hope, just as much, that you continue finding ways to care without losing yourself in the process."
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