Physiology versus Psychology ---> Medicine versus Psychiatry

[Boojatta]

Laura Schlessinger has a degree in physiology, not psychology. Although the study of physiology up to and including the Ph.D. level might give one the title "doctor", it does not necessarily prepare one to give good psychological counselling.

Why is it that people prepare to become psychiatrists by becoming medical doctors? Does the study of medicine up to and including the M.D. level prepare one to give good treatment to those who are having interpersonal or emotional difficulties?

[Syncronaut Seven]

1. Psychiatry is a sham, the main thrust seems to be to help people

Re-integrate in to a sick society. Never looking at the valid concern that the whole societal structure is a lie, and perhaps the sickness of the soul and mind is a natural response to that lie.

[ArtH]

2. Psychiatry v physiology

The principal issue here is whether a problem is the result of something that can be corrected by pharmaceutical means or whether it involves the much more complex matter of volition and emotions.
Interestingly, the breakthrough of S. Freud was actually a stumbling block, since it generated psychoanalysis, a tool more suited to describing some of the ontogenesis of pathology far more adequately that describing ways of attaining good function.
If there is a serious chemical imbalance, volitional change may be nearly useless. However, the tendency to diagnose something as a chemical problem, is vastly overdone (in my opinion).
From someone who initially thought that Dr. Laura was ridiculous I have come to have enoprmous respect for her insightfulness. Her therapeutic position, that taking personal responsibility after assistance into insight, (instead of spending years babbling on a couch which is the way I had been trained to think about such matters) is almost infinitely superior to anything else I am aware of.
I know, she can be tough to take, but don't underestimate her skill and competence.

[Sanity Claws]

3. no

but they are able to prescribe antidepressants and monitor their usage. Psychotherapists and other non-M.D. medical providers can't do that.
In many hmo settings, psychiatrists are limited to prescribing pharmaceuticals and monitoring their effects; actual psychotherapy is often done by persons with MSW's or MA's in psychology.

[ArtH]

5. response to "no"

You are quite correct. That's exactly what occurs, and it has been so for years, in fact for decades.

[Warpy]

4. She's an exercise physiologist who had one semester's

training in (I believe) marriage counseling. She is unqualified by both temperament and training and really should be off the air as doing more harm than good.

Psychiatrists are medical doctors, and as such can prescribe a full range of medications. Doctorate prepared psychologists may have limited prescribing privileges in some states, but not in others. Masters prepared psychologists and social workers can offer licensed family therapy and individual counseling.

Medical schools are increasingly concentrating on bedside manner as they train physicians now, a stark contrast to the training they got even forty years ago, when the emphasis was wholly on chemistry and mechanics in describing and treating disease processes.

[Name removed]

6. Deleted message

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[Warpy]

7. Only if you buy into blaming the victims

of a sick society and an unjust economy for all their troubles.

I don't buy it. She may be articulate enough, but she's doing damage.

[bloom]

8. I think there is something to be said

for it being the same person who is knowledgeable about psychotherapy AND is knowledgeable about treatments and reactions and monitoring changes in a person.

I think it's getting too expensive - generally - for individuals to pay (and HMOs wouldn't want to) for that sort of comprehensive treatment.

It's more common at clinics to have a whole slew of people - with the people who actually spend the most time with the patient having the least training. The psychiatrists and sometimes even the PhD psychologists become more like consultants. One of the problems with that system is that people who really hate talking to people to begin with have to give their story to something like 5 or 6 people. I know people who that alone discourages them from seeking treatment.

[Sgent]

9. Something to point out here

Psychiatrists undergo another 3-5 years of postgraduate training AFTER recieving their MD degree --the training is additional specialist work in neurology and psychology.

Things psychiatrists are trained to do (to a lesser or greater extent) include reading imaging studies (MRI's, etc), certain types of surgery, ECT, neurodiagnostic techniques, etc.

They also have training similar to Ph.D. psychologists in the admistration and scoring of psychological tests, psychotherapy, etc.

Psychiatrists have the most training in the treatment and diagnosis of psychiatric diseases. This includes a large amount of training ruling out non-psychiatric causes, concorrent morbitity, etc.

[HuckleB]

16. That's what is supposed to occur.

However, most get some of that but not all of it.

[varkam]

10. But insurance companies dont like psychiatrists.

From what I understand, most insurance companies won't cover traditional therapy with a psychiatrist - as they make the big bucks. That and while psychiatrists might receive some counseling training, it's certainly not as thorough as a PhD psychologist. Then again, they do receive a whole hell of a lot more training in physiology, psychopharmacology, pharmacokinetics, etc than psychologists do. Which is why they push meds - the tail wags the dog.

I think a lot of people have an aversion or disdain of pharmacotherapy. I will agree that I think meds are pushed entirely too much, especially in our society. But efficacy studies have revealed that by and large, for most people the best treatment is a combination of pharmacotherapy and behavioral intervention. At a clinic I used to work at, we would not Rx meds for patients unless they were also in therapy at the same time.

[MountainLaurel]

11. It's the exact opposite for me

My insurance plan's mental health coverage will automatically cover a visit with an MD (i.e., a psychiatrist). However, you have tyo get preapproval and jump through various hoops to get coverage with a therapist or a psychologist. I'm guessing the plan thinks that straight pharm treatments are more cost effective than cognitive and behavioral approaches.

[varkam]

12. On my plan it's just the opposite

I guess it's a plan by plan sort of thing, or perhaps I'm simply mistaken.

[MountainLaurel]

14. The plan and the employer n/t

[Warpy]

13. Psychotherapy of any type is labor intensive

and the labor is by a highly educated professional therapist, so of course insurance companies are allergic to it.

As psych drugs keep getting more expensive, though, maybe the insurance companies will rediscover that the length of time many people need to be on antidepressants and anxiolytics can be greatly reduced by the talking therapies.

Or maybe the country as a whole will rebel and we'll finally see single payer.

[HuckleB]

15. Actually, most do receive as much training in therapy.

Most psychologists have much more training in psychological examinations of various types, as that is where the money is for them, not in therapy.

[varkam]

17. Cool.

thanks for the info