Scott Alexander shares his experiences and reflections as a final-year psychiatric resident, discussing communication techniques, challenges in psychotherapy, and the anxiety of managing patient risks. Longer summary

Scott Alexander reflects on his experiences as a final-year psychiatric resident. He discusses the differences between resident years, the challenges of dealing with patients and attendings, and the techniques he's learned for effective communication. He also shares his struggles with psychotherapy, his frustrations with psychoanalysis, and the constant anxiety of managing suicide risk among patients. The post ends with Scott contemplating the 'reverse lottery' nature of psychiatric practice and how a patient's suicide attempt has affected his approach to patient care. Shorter summary