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Culture War Roundup for the week of April 8, 2024

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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.