A psychiatrist is a Medical doctor who, after finishing the long qualifications necessary to become a General Practitioner of medicine, has taken up a speciality, in mental illness.

In addition to the psychic bruises and scrapes, fresh traumas and even deeply-seated old wounds from childhood that are the stock in trade of the psychologist, psychiatrists must help people with severe or organic problems like Schizophrenia, Manic-depression or Psychosis that are beyond the help of a psychologist.

Unlike a psychologist or therapist, who is not a doctor and is qualified merely to talk to you about your problems, the psychiatrist is allowed to prescribe medication. Western Society is over-medicated to be sure, but you cannot control a chemical imbalance like Schizophrenia by saying "tell me about your childhood".


I really don't know why the above writeup is the subject of so much heat. It's a fairly simple factual definition of the consensus view. Disagree if you must, but accept that is how the profession views itself.

For Cletus the Foetus's sake, I will reply: We have come a long way in understanding the human mind since the days of the inquisition. We even know a few treatments that work most of the time.

Unlike demons, chemical imbalances (or if you will: unusual, different states) can be proved to exist by measuring body chemistry. consciousness is a chemical phenomenon. When these states affect behaviour in such a way that the person cannot cope with everyday life, a psychiatrist's skills are needed.

Yes, there is potential for abuse. That's how it is with most things. Yes, there have been abuses. Does that make my definition wrong? Did I imply anywhere that people or medical science are perfect?

Yes, there are people who are different, handicapped or even gifted by their mental chemistry. They deserve the right to live their own lives if they so wish. You cannot claim that they are the only ones in mental hospitals. I know at least one person who has seriously come off the rails and last I heard has voluntarily checked himself into psychiatric care as he could not cope anymore. He thought he might be Jesus but hadn't cleaned his apartment in months. Different but equal my ass. I know from talking to psychiatric doctors that there are people with even more serious mental problems. You cannot deny that some of them genuinely need care.

Post-modern literary theory about it all being relative to your point of view, with no one right way is all fine and well up to the point where it hits reality, and someone becomes a danger to themselves and others.

Though it is true that a medical doctor's training is far more reductionist and scientific than the literary, cultural arts student background of the psychologist, this is what is needed in some cases, i.e. when the cause of the problem is in the organic brain and body, not in the experiences of the personality.

The psychiatric doctors that I know socially are warm, compassionate and caring people, who work with some desperately ill patients. Please do not deny them the ability to do any good.

I like what several write-ups have to say about distinctions between psychiatrists and kinds of psychotherapists, who may tend to come from training models other than the medical model.

Recent experience, in which I have needed psychotropic drugs (namely Depakote and Seroquel) to bring me back to mundane reality from a chain of events that included a recent bad drug interaction (see Celexa diary for some hints of the back story here) have put me in contact with both my regular therapist, who I've seen almost weekly for over three years, and new contacts with two psychiatrists.

Conversations with my therapist, in which we have reaffirmed my hypersensitivity to drugs (something also confirmed in blood tests at a local psych hospital and in outpatient follow-up) boil down to this:

A key difference between psychiatrists and other therapists is that the psychiatrist tends to come from a reductionist point of view. Rather than deal with a wholistic approach to mental process, wellness and growth, there are specific thought patterns that are pathologized and which are identified as being those we need to treat with drugs.

Now in one sense I agree with the psychiatrist. Without the anti-psychotics I was given in the emergency room who knows how long or even whether I might have come back from where I went? Set aside for the moment that my experience was subjectively closer to a shamanic vision quest than it was to a simple period of "losing touch with reality."

There's little means of defining one separated from the other.

In a sense, I'm certainly grateful my stay in "unreality" (or a real that transcends mundane reality was so brief... I had lots to do back here, it wasn't a good time for a vacation inside my own head. It will be a big adjustment coping with the new addition of a nanny who will be helping me to ensure that my daughters remain safe at all times, even if I do happen to have any kind of relapse.

I've also heard from at least one family member who spend a week in the state I described to him. I have no idea whether I could have stood a week in that state of mind. Most of an afternoon was terrifying enough for me.

But on the other hand, there were images and feelings I was encouraged to downplay (by my longtime therapist), mainly to enable me to get out of the hospital on a reasonable schedule and get to a space where we could start working constructively with images and gifts I got from that brief time in another world (or in the larger world, as I would put it, since that world encompasses ours and many others). A psychiatrist who hadn't known me for three years might tend to frame these gifts more as psychotic ideation or some form of delusional thinking, where I experienced them as religious visions or instances of Jungian archetypes being presented in especially vivid and immediate form. (To be fair, by the time I was released I felt I had an understanding with the hospital's attending psychiatrist that gave due honor to the visions, while recognizing the severe risks that most anyone exposes herself to if she were to choose to remain in that world, or could not find a way out of that world.) I will probably never know whether I found my way out or whether the drugs were the sole factor enabling that escape from the spirit world.

A therapist who has known me a long time could listen and say, yes, this person is back to a baseline where they were before hospitalization... as in touch with "reality" as before... while a reductionist, "reality-based" psychiatrist might have a much harder time of it. Also, for legal and economic reasons, psychiatrists at present tend to spend most of their time and energy pushing psychotropic drugs and frankly, given my sensitivity to such drugs, I frankly hope that recent progress dealing with some major psychic hairballs puts me in a place where fewer (not more) drugs will be needed moving onward from here.

On the other hand, having recently been diagnosed as bipolar on top of pre-existing issues, it may be wishful thinking to imagine that I will be moving away from prescription drugs rather than into more of a dependent relationship with them.

Another Mind-Fuck Game.

Gather some people - hopefully at least 5 who know the game, and one who doesn't. Send off the person with whom you will be fucking, so that the rest of you can agree on the one rule of the game. Namely, figure out a pattern that denotes who each of you will represent. Commonly, you will pick the person on one side of you - say the left. Any questions asked of you, you will answer as if you were that person. Other variations could be all celebrities, or whatever, but I find that sticking with the people present is much funnier. Bring the fuckee back and explain to them that they are a psychiatrist. They will need to basically figure out what the hell is going on by asking questions. Let the fun begin.

moved here from the craziest bastards on earth

We're all a little worried that we're insane. If we weren't then we might actually *be* insane, well most of us, anyway. The point is although we recognize faults in our own reasoning, we seldom if ever do anything to fix these unless we regard them as being serious. In most cases the problems are transitory: depression, anxiety, hallucinations, they all pass. We have to accept this because most of us don't study what these things actually are, and how and when to fix them.

You're average Psych person is in a different position. The object of their curiosity is the human mind, and it's flaws are the substance of their own analytical tendencies. This would be fine if one had a perfect mind, and only saw such flaws in others, but when you begin to see them in yourself, it has an unnerving effect. Not least because you know in most cases what the worst case scenario could be. Psychiatrists are actively discouraged from self medication, and it undermines one's reputation as a Psych professional to seek advice from others in the field, especially when you regard them as being less experienced than you. How many computer scientists would pay Microsoft Support £2 a minute to talk them through a reboot if WinXP crashed? Not many I daresay. However in the mental realm this pride and personal assessment of other's ability to help plays a big part in the growth of mental problems.

If you combine this with the eventual realization that the problem may have grown out of their control, you can imagine the impact this would have on their ability to function.

For the record I don't think Psychiatrists and Psychologists are more crazy than the rest of us, I think they just as crazy, but they either have to cope with their issues exceptionally well, or hide them even better. Sometimes the pressure of doing so on a daily basis can lead to the tragic consequences that Dannye described. Even a shrink needs someone to lean on, sometimes.

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