Psycho-Babble Psychology Thread 778231

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Are some psychiatrists better than others?

Posted by Michael83 on August 24, 2007, at 0:24:28

If you have a very complex and unusual issue, are there such things are "really good" mental professionals?

Or are they all the same and what they'll do is just ask you to talk about your feelings and write you a prescription? Or is it possible to find truly talented pdocs for very specialized/unique issues and deeply understand complex problems?

 

Re: Are some psychiatrists better than others?

Posted by Racer on August 24, 2007, at 0:38:55

In reply to Are some psychiatrists better than others?, posted by Michael83 on August 24, 2007, at 0:24:28

First of all, most psychiatrists these days don't do therapy at all. They leave that to the psychologists -- and I'll say no more about that.

Psychiatrists these days mostly just do medications, and some are certainly better than others. Unfortunately, it's mostly hit or miss.

Psychologists, and other counselors and therapists, also have a huge spectrum of talent. There are also a huge number of different types of therapy -- short term, longer term, psychodynamic, cognitive, behavioral, cognitive-behavioral, etc. Within each type of therapy, with each type of practitioner, you'll find a very wide range of abilities. (Kinda like any other career path, you know?)

I've seen great therapists, lousy therapists, and in between therapists. Ditto psychiatrists. That's why, when you find a good one, it's so good -- FINALLY, someone I can work on these things with...

I hope that helps answer your question.

 

Re: Are some psychiatrists better than others? » Racer

Posted by lcat10 on August 24, 2007, at 12:11:34

In reply to Re: Are some psychiatrists better than others?, posted by Racer on August 24, 2007, at 0:38:55

Gosh Racer; I am going to have to disagree with you. My previous therapist was a psychiatrist, and my current therapist/analyst is a psychiatrist. The first guy was good for all the medical problems I developed all at once and was freaking out over. The one I have now has expertise with eating disorders and trauma/abuse. He has been working in the field of some 30 years, and went through psychoanalysis and training and is now a suprevising and training analyst besides doing therapy and running a residential program for persons ages 18 to 30. I know quite a few psychiatrists in Chicago who do therapy and were trained to do therapy. Plus, when I was doing my postdoc at MC, all of the psychiatrists were trained to do therapy.

RealMe (OzLand)

 

Re: Now a very old name is popping up; I give up » Racer

Posted by lcat10 on August 24, 2007, at 12:13:43

In reply to Re: Are some psychiatrists better than others?, posted by Racer on August 24, 2007, at 0:38:55

I don't know what happened; I did not really look at the name, but a really old name pops up now when I post, EGADS! Sorry.

RealMe

 

Re: Are some psychiatrists better than others? » lcat10

Posted by seldomseen on August 24, 2007, at 12:36:30

In reply to Re: Are some psychiatrists better than others? » Racer, posted by lcat10 on August 24, 2007, at 12:11:34

I think it depends on a lot of things, but I had to look high and low in my area to find a psychiatrist that also did psychotherapy. It took several months to find one, and I'm around a pretty big academic center.

I do not dispute that psychiatrists are well trained to DO psychotherapy, but it may be that once they are out in private practice, they stick to the meds.

Don't know, just my opinion and experience.

 

Re: Are some psychiatrists better than others? » Michael83

Posted by Dinah on August 24, 2007, at 12:57:25

In reply to Are some psychiatrists better than others?, posted by Michael83 on August 24, 2007, at 0:24:28

My psychiatrist (psychopharmacologist) would run screaming if I mentioned feelings.

I have no idea if he's good or not.

But I would find it hard to believe that there's any profession or specialty or vocation or anything else in the entire world that doesn't have people of varying degrees of skill. How to assess that is something else entirely.

 

Re: Are some psychiatrists better than others?

Posted by Honore on August 24, 2007, at 15:24:15

In reply to Re: Are some psychiatrists better than others? » lcat10, posted by seldomseen on August 24, 2007, at 12:36:30

It's probably a generational thing-- prior to the maybe 1980's or so, psychoanalysis was field open purely to MDs-- no (Freudian, ie prestigious) analytic institute accepted anything but MDs--by and large. This was not an absolute, but a strong preference. I don't know about Menningers, but places like the NY Psychoanalytic, etc.

But with the growing influence of biological psychiatry and the burgeoning of psychology and psychodynamic therapies, therapy became over time more the province of psychologists, and prescribing medications became more the province of MDs. There's still some overlap, of course-- but the assumption that psychiatrists are primarily psychopharmacologists is at least somewhat time-bound.

Of course, it's probably a given the some Xs are always better than some other Xs-- substitute any field, or occupation for X.

Honore

 

Re: Are some psychiatrists better than others?

Posted by sam123 on August 24, 2007, at 18:15:46

In reply to Re: Are some psychiatrists better than others?, posted by Honore on August 24, 2007, at 15:24:15

I have never had a psychiatrist that did anything other than deal with meds. There is not a lot of time in a medical degree for a study of psychology.

There is a big difference in docs. Sometimes you get what you pay for. The one I see now is the most expensive one I have ever seen and the best.
HMO docs gave me little time for my co-pay.

Like Racer said, find a good one and stick to them.

 

Re: Are some psychiatrists better than others? » Michael83

Posted by Poet on August 24, 2007, at 18:26:50

In reply to Are some psychiatrists better than others?, posted by Michael83 on August 24, 2007, at 0:24:28

Hi Michael,

My first psychiatrist did therapy and psychoanalysis and offered to do both meds management and therapy with me at our first appointment. I had a therapist already and didn't want to see him for anything, but meds so I said no.

He went out of the insurance network and so now I see Dr. Clueless who is a psychopharmacologist, but also is into yoga, tai chi and breath work. Which suits my style much more than the first pdoc did even though he did do therapy.

I can't really say if some pdocs are better than others as I've only had two, but Clueless despite my name for her has nailed me on being sensory defensive. So I would give her the edge over the first one.

Poet

 

Thanks for the responses everyone...

Posted by MIchael83 on August 24, 2007, at 23:50:09

In reply to Re: Are some psychiatrists better than others? » Michael83, posted by Poet on August 24, 2007, at 18:26:50

But I think I confused psychiatrists and psychologists.

I have never been to anyone of these and I just wondered if there are these sort of professionals who could deal with my problem, as it's very uncommon and complex.

 

Re: Thanks for the responses everyone...

Posted by widget on August 25, 2007, at 7:04:13

In reply to Thanks for the responses everyone..., posted by MIchael83 on August 24, 2007, at 23:50:09

I just read your question and am fascinated by the range of responses you have received. My psychiatrist does real psychotherapy and is also very capable in the medical/psychopharmecutical area. My previous psychiatrist was the same. That said, they seem to be the exceptions where I live (middle of the country) and I would imagine it is different on either coast. My psychiatrist explained that some training programs often ignore psychotherapy training for doctors and focus on medication. He feels this is creating a huge number of fellow psychiatrists without much of a clue as to how to talk to patient. I agree. I think it is time for psychiatry to reclaim psychotherapy/analysis. My psychiatrist is went through his own analysis and went to an institution with a heavy emphasis on in-depth therapy. He uses dream analysis at length and it has helped me amazingly to get to the unconscious level which is well hidden. I think its the only way to go if you can get so lucky.

Otherwise, use a well trained psychologist or even therapeutic social worker (although my experience with the lisenced social worker could only take me so far and focused on more situational problems.) This is a tough area. I usually feel best about a referral from another patient. There's lots of choices out there. Be sure you ask all the questions during your in-take interview as there may be "deal breakers" if the candidate for therapist is not adept at dealing with certain types of therapy. Remember, you are also interviewing them. Good luck!

 

Re: Thanks for the responses everyone... » widget

Posted by RealMe on August 25, 2007, at 12:52:56

In reply to Re: Thanks for the responses everyone..., posted by widget on August 25, 2007, at 7:04:13

I agree with you widget. I am in the middle of the country too, and even so, I know there are folks on either coast, psychiatrists, who are trained to do therapy. When I was in training and doing my postdoc in psychology at Menninger's in the 90's, the residents were still being trained to do therapy, and all of the psychiatrists there did therapy as well. I was trained to do indepth therapy too as a psychologist, and many of the social workers were too.

For my own therapy with a psychiatrist now who is an analyst and also prescribes my antidepressant, sometimes I am not sure if it is a blessing or a hinderance that I know so much. Well so far, I don't think it is getting in the way. My therapist enjoys the fact that I can be so transparent, and though it is painful at times, I guess that is a good thing.

RealMe (Ozland)

 

Re: Thanks for the responses everyone..to Real Me

Posted by widget on August 25, 2007, at 22:56:33

In reply to Re: Thanks for the responses everyone... » widget, posted by RealMe on August 25, 2007, at 12:52:56

To Real Me, Thanks again for your response. I wonder how being so well trained in psychology can hurt your process? I am also a psychologist but this therapy (psychoanalysis) is my real education. May I ask a dumb question? What is csa? Sorry, don't know. But, truly appreciate the support. And, I believe, wholeheartedly, in depth analysis. Sincerely, Widget

 

Re: Thanks for the responses everyone..to Real Me » widget

Posted by RealMe on August 26, 2007, at 0:25:56

In reply to Re: Thanks for the responses everyone..to Real Me, posted by widget on August 25, 2007, at 22:56:33

csa stands for child sexual abuse.

Trained psychoanalytically myself.

RealMe (Oz)


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