psychiatry

[Adam Blatner]

Connie Miller asks some good questions!  
Okay, I'll take a stab at them. 
1. With all the diffferent alternative therapies along with the many spiritual exercises and forms of meditation today, are psychiatrists are more limited in their approaches to the client as opposed to  other health care professionals.? 
       ab: are they more limited? Actually, if they desire, they have the right to avail themselves of the broadest repertoire of treatment approaches. Are they limited by their sense of what is considered "appropriate" by colleagues or from fear of malpractice suits?  Maybe somewhat. Are they limited within their own minds and education? Undoubtedly, most psychiatrists don't learn about a whole lot of stuff. I'm not sure, though, if any professional group isn't limited to an equal degree, only about all sorts of other things. Non-medical professionals don't get much continuing training (and even less in their primary training) about all sorts of stuff, so the argument may involve which things are really important or effective?

    2.  Does the psychiatrist traditionally take a more receptive role with the client?  The techniques of free association, psychodrama, dream work, hypnotic age regression, breathwork are all techniques that allow the unconscious to rise to the surface and help one to access their spontaniety and be able to "let go".
      ab: In the past, when psychiatry was dominated by psychoanalysis (1945 - 1970 or thereabouts), more were more analytic and receptive; Not since. However, some psychiatrists do use a range of psychotherapies. 

   3. What is the presenting issue that the client brings into the session?    AB: session or intake? My motto is first, do a good diagnosis. That's not a matter of slapping a label on, but rather finding out what's going on? Working up a good formulation. 

     4. Is the client defining the presenting  issue to be religious and/or spiritual?    AB: Rarely, in my experience. 
     4a CM:  For example, an individual may be seeking clarity regarding his/her relationship with a priest or rabbi?   AB: Rarely in my experience. Others may have had more of this kind of experience. I don't know.

   5. Is the  presenting issue not overtly spiritual in nature, but leads  to source conflicts that are? For example, someone may be exploring a deep fear of abandonment and is searching for support in the living of his/her life,and wanting to become aware of a comforting spiritual presence. 
         AB: I tend towards this somewhat. Also, there was increasing attention given to transpersonal psychiatry and spiritual issues in psychiatry---although it was a far from dominant theme--- in the 1990s and beyond. 

   6. Is the individual coming in for exclusively spiritual counseling?   AB: rarely to psychiatrists. 

    7. At the other end of the spectrum are religious counselors who have a specific dogma of belief and a mission to save or convert clients, as well as therapists who have deeply personal unresolved spiritual conflicts. Whether conscious or not, such a therapeutic stance toward clients will inhibit the client’s full exploration of their feelings, doubts, fears and longings.

         AB: Yes, and good schools of chaplaincy and pastoral counselors address this with great energy. I fear that there are less rigorous "schools" and programs that let zealots through, though. So we need to really interview candidates for programs and not assume that their degree means they're adequately or appropriately trained.



My thoughts, Blessings, Connie   Ab: what did you think of my responses?  Warmly, ADam
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