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All well and good, might as well condemn biologists for Lysenkoism at this point.
None of those are really a knock against the field as it exists today. I'm here to dish out drugs, that's why I'm a psychiatrist and not a psychologist.
And most practising psychiatrists, unless they're still seeing patients at 80, have nothing to with any of them really.
Don't get me wrong, I certainly hope and expect that we have learned from those mistakes. I'm just saying that when you have that kind of history, it's justified and expected to be careful.
Psychology/Psychiatry is useful, but it is also dangerous and therefore ought to be treated with a mind to that danger, lest we repeat the mistakes of the past.
And for the record, I do think the exact same thing about biology.
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Interesting response. I have always assumed, or more correctly, hoped, that psychiatrists had some degree of expertise beyond psychologists that was not simply the ability to, as you have put it, "dish out drugs."
The dishing out of drugs (for whatever) seems very (read: too to my way of thinking) common in Japan at least. Considering most medical interventions are created with the general human in mind, and are therefore prone to error when prescribed for individuals (whose idiopathic digestive, cardiovascular, endocrine, and central nervous systems are all slightly different), I am sometimes surprised medicines work at all. In fact I doubt that many of them do without causing other issues (see: statins). MDs at least in my own experience as a non-King with no real personal physician of my own, seem more likely to send people to the pharmacy (where, at least here, there is often rigorous questioning and examination of one's 薬手帳 or personal drug diary that everyone's supposed to carry to the doctor, that has every prescription drug you've taken for the last however many months/years logged.) than sit down and ask about diet, exercise, family history, etc. to get at whatever the hell may be causing the current complaint.
I guess I am hoping psychiatrists are at least interested in possible causes--of, say, depression--rather than being focused, from the moment introductions are uttered, on measuring the patient up for which drug will induce the sweet, sweet, happiness (or whatever).
There's plenty of interest in and research being done into the causes of depression, from very many angles, both biological and psychological. I don't think any of it's been productive, but that's a separate issue.
I am not completely unaware that this kind of research is out there, but I think my assumption has always been that psychiatrists are much more aware of the cutting edge of such research, and can therefore apply whatever conclusions have been made to individual cases--assuming individual cases are explored to some degree and not (simply) medicated away. I realize on writing this that I sound possibly naive here, but I, and I assume most people even if possibly not most people here, make this same assumption about most doctors, including gastroenterologists, endocrinologists, surgeons, etc That if I have some physical ailment that they've done the time in med school to not just prescribe some inhibitor or agonist, but they also have some educated guess as to what might have gotten me to the point of peptic ulcer, or insulin resistance, or whatever. Were a doctor to say something like "You're pre diabetic, here's a pill" I see that as a failure of medicine.
Likewise, the psychiatrist. I understand the mind is a locked box to some degree.
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I mean, we obviously study most of the same topics as psychologists do, we have the additional benefit of prescription drugs where simply talking to the poor bastard doesn't suffice.
Doctors are in relatively scarce supply, so there's a degree of specialization of labor, if it's cheaper and easier to let the people trained particularly in talking handle that bit, that frees us up to do the job of doling out drugs. But I struggle to think of anything a practising psychologist can do that a psychiatrist can't. I consider the ability to make problems go away with pills a big plus in my book.
But there's a tradeoff here, the time you spend with a psychiatrist who usually charges much more per hour, and that time is better spent with less talking and more prescribing, within reason.
Of course we argue about the causes of depression and try to understand the pathophysiology of it better, but even where we don't get it, at least we have robust empirical evidence that many therapies beat placebo, such that even if it's not actually a deficiency of serotonin, SSRIs still work modestly well in many if not most people. There are plenty of drugs with much more dramatic impact on psychiatric illnesses, I doubt any amount of psychological intervention would cure my ADHD while Ritalin does.
This "talking to the poor bastard" seems to me the point of the profession, or at least, to my mind, should be the pointy edge. The first step. The main thing.
I have precious little faith in psychologists, having known several in my life, but more in psychologists than therapists. Psychiatrists I would hold in highest regard; if there's a hierarchy in my mind they'd be up there at the top of the pyramid.
I suppose your speaking of cure here is relevant. There is this sense that we need cures and of course for many things cures are exactly what we need. I'm just as interested in causes and possible reversibility. Like when your liver is going, taking drugs to help the liver is less of a helpful strategy than quitting alcohol or whatever else you're doing to destroy your liver. That one is doing. Not you in particular.
I don't mean to come at you like this in any sort of aggressive way, I am just a skeptic of drugs in general, as I've said/written to you before.
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