If you are one of the “other” kinds of psychiatrists, who deeply believe in psychological trauma recovery and are trying to fix the system from the inside, then I sincerely commend you for your work.
If you are one of the “other” kinds of psychiatrists, who deeply believe in psychological trauma recovery and are trying to fix the system from the inside, then I sincerely commend you for your work.
Ironically, most US readers of HN will never have seen such a clinic, as the only places actually staffed this way are things like county mental health departments in states where they can get funded.
So, anyway, psychiatry training REQUIRES that each of us provide many hours of supervised psychotherapy. Some training programs are better than others, but we all graduate with a working knowledge of psychotherapy. Many of us have less opportunity to use it than we would like.
Which brings me to my final point: it's not either / or. That's a false dichotomy. It's about the right tool (or combination of tools) for the job. There are plenty of problems that there is no pill for, and a few problems that no amount of talking about it is going to fix. Horses for courses, and all that.
edit: I'm sorry to see you are getting downvoted. I think many people arrive at the same conclusion you have, based on their experiences. I can totally understand how you arrived at that opinion.
Your parent comment:
“I have never worked at any addiction program where psychological and behavioral interventions weren't the primary mode of treatment.“
Your latest comment: “Nobody will pay psychiatrists to do talk therapy... for this reason we end up doing mostly medication management...”
So let me get this straight. You are currently doing mostly meds, and you’re presumably working at “one of the good places” where psychological methods are the primary mode of treatment. So either you are completely okay with being relegated to a secondary role in treatment (unlikely, given how psychiatrists tend to dominate the conversation thanks to that Dr. title), or, more likely, you are not being sincere when you state your belief that psychological methods are primary. Which is exactly my point. Psychiatrists by their nature and training don’t believe non-pharma methods are the primary solution. Most really try to pretend that they care, but end up prescribing meds in the end. Which was my original point.
I've spent years working with past trauma and many hours in therapeutic circles with traumatized people, so I completely get where you're coming from and our views are probably sympatico. But there's a risk, when one's opinions come from the same intense experiences as one's feelings do, of not leaving enough space for other people. On HN, other people means other commenters, especially ones who are coming from an opposite position. Forum comments tell us very little about who we each are, and inevitably we sketch in the gaps from material of our own past experience. This leaves exchanges fraught with misunderstanding, especially when feelings are strong. We're all responsible for guarding against that.
Looking back on this comment, I agree that I could have worded this more respectfully. I will strive to do so better moving forward.
I would hope that HN is a space where you can call out illogical ideas, which is what I was trying to do. I reacted emotionally because I felt like I was being trolled, which is extremely common for anyone who exposes themselves by speaking about trauma. I can see now that the intent may not have been to troll me.
However, I do feel like I’m being singled out a bit unfairly here. Again, not excusing the tone of my own comment, but I’ve received a few replies that feel at least as aggressive as my own. There’s one in particular referring to the “stench” of my comment that felt a bit harsh. All I would ask is for the same standards of civility to be applied to all members.
If you see that comment and legitimately believe that mine was noticeably more over the line, please let me know.
The best ways I know of to avoid this are to stick to describing one's own experience and to look over one's comment several times for anything unduly personal. It can sneak in in a lot of ways.
Your comment really isn't with respect when you make this assumption about someone's profession based off no knowledge of that person's chosen career path.
I'm not sure what kind of a person knows many psychiatrists but doesn't understand that the boundary between psychiatry and psychology isn't some high garden wall whereby a psychologist tosses the ball over when they can't figure out the case.
To those I have a serious question: why did you choose psychiatry over for example a PsyD degree? And: what are the key data points that make you believe that the pharma-centric approach is the one worth devoting your career to?
The patronizing stench of this comment aside, you’re attempting to wedge these two careers into the same hole when they are apples to oranges. At their foundation, the curriculums between the two are nowhere comparable.
My psychologist has been taught to conduct _psychotherapy_ at an expert level. My psychiatrist is trained to be a _medical doctor_ on all bases with additional expert knowledge in their sub field.
While you may have a certain disdain for the field of psychiatry, attempting to devalue the importance of the balance they maintain for a patient stems from ignorance of what they do.
That falls under what the site guidelines refer to as name-calling and ask you not to do.