Re:Psychanalysis/ The Natural Order of Things

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From: Judy Seigel (jseigel@panix.com)
Date: 09/02/02-03:12:02 PM Z


On Sun, 1 Sep 2002 ARTHURWG@aol.com wrote:

> Most contemporary psychiatric practice seems to center on which drug or
> combination of drugs to use, or on various forms of behaviorism. Then there's
> all the psychotherapists who have an MSW degree and have no idea what
> they're doing and often do more harm than good. Arthur

Since I was witness to my husband's training as psychiatric resident 35 or
so years ago, and his descriptions of training given the psychiatric
residents he teaches today, not to mention my own observations about
vicissitudes of "mental health" biz in the interim, I am moved to comment:

In the '60s, psychiatric residents were trained in "psychodynamics,"
generally, or at the best hospitals, with a very psychoanalytical (read
"Freudian") bent. Today, for many reasons, most of them having to do with
medical economics (rise of the HMO, which only pays for a limited number
of visits, quick effects of psychotropic medicine) but also remarkable
advances in psychopharmacology, residential training has little
psychodynamics, while, to be boarded, a psychiatrist has to pass not just
psychopharmacology, but neurology, a field now also much enlarged.

In the meantime however, the fields of social work and psychology have
vastly improved their training in psychodynamics -- an MSW in social work,
for instance (depending on where they trained) is, odds are, better
equipped for "talking cure" than the MD psychiatrist, unless the MD has
done a postgraduate course as some elect to do.

But one who is contemplating this .... let's say fascinating & potentially
lifesaving.... adventure MUST MUST MUST ask about the "therapist's"
training. I've watched folks go into "therapy" without a clue about the
"school," degree or training of the "therapist," simply taking it on faith
because a friend "loved" them. And/or being embarrassed to ask. Would you
buy a used car no questions asked? And if you don't feel free to
question/challenge the therapist in such areas... finding out why not
should be very productive.

The first question, after training, "modality," etc., is have they
themselves been through therapy, and of what nature. If a therapist has
not at least done a walk-through, odds of malevolent counter-transference
increase.

J.


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