Archive for December 22nd, 2009

Pilgrimage Statistics

Consecutive Days Riding:  73                              Consecutive Days Blogging: 74

Today’s Mileage: 5                                            Total Trip Mileage: 636

I’m dictating today’s posting in front of a blazing fire.  It’s a frosty clear morning as I continue my efforts at clearing away dead trees and branches on our property.  I’m sure fire has always had a lot of symbolic meaning. We appear to have both a fascination towards its flickering mysteries, and a need for its illumination and heat.  I believe it also speaks to our need to let go and release that which is old and rotten to make way for the new.

Look within to find the light!

I had not intended to talk about flame and fire today.  I want to address today’s blog to a particular individual.  I have never met him, but I have seen his words and his photo in the daily paper on numerous occasions.  I am speaking to Charles Krauthammer, or should I say Dr. Krauthammer.  He is a Washington Post political commentator, who in today’s paper noted that he was going to do something he rarely did, be self-reflective!  He wrote: “I’m not much given to self-reflection – why do you think I quit psychiatry? – but I figure once every quarter-century is not excessive.”

Your vision will become clear only when you look into your heart.

 Who looks outside, dreams. Who looks inside, awakens —Jung

Venus looking in the mirror.

 That’s a long time to go without holding up the mirror of self-reflection, to explore how one finds meaning in life, and the consequences of our choices. When my partner, who read me the column aloud, noted his training in psychiatry I responded: “That explains a lot!” Let me clarify what I meant.

Over the course of my 25 years as a Clinical Psychologist and therapist, I have often explained to people the difference between psychology and psychiatry.  Psychiatrists are first and foremost trained as medical practitioners.  They are taught a biological view on the causes of problematic behaviors and given prescription pads. Pathology and problems are traced back to some biological imbalance. Then they find the right drug and voila! They have found the solution. Talking psychotherapy is no longer a main component of psychiatry.  In fact, I have been told that some psychiatry programs no longer require it as part of their training. I have a friend and former student who is currently struggling with a serious psychiatric illness in her family. Much of her frustration centers on the fact that many of the psychiatrists her family member has contact with are foreign born and barely speak English!  Psychotherapy is pretty much out of the question and drugs are the only prescription.

Missing pieces!

Psychologists on the other hand, have no prescription pads.  They must rely on their abilities to listen, to clarify, to uncover and to explore with the client.  This therapeutic process explores the client’s past and current perceptions, beliefs and circumstances to uncover the often multidimensional nature of their problem.  Therapists do not carry “road maps” for what the client should do or who they should become.  They advocate a “process” that helps the client explore and find their own road map. We are less a prescriber and more a mentor.

 Prescribers can afford to see the world through their own lens or perspective, and may find little need to check their lens (cleaning or changing them).  They only need to be certain about what they prescribe. Mentors on the other hand need to constantly hold up a mirror to make sure they are following the same self-reflective process of growth and discovery that they challenge their client to engage in.  They need to see the world through the patient’s lens/perspective; they need to be humble that it is not the same as theirs.

I now understand why I seldom make it past the first couple paragraphs of Dr. Krauthammer’s columns. It’s not just that I am liberal and he is conservative, it’s not that I am closed minded, it’s because he has a process and perspective much like a prescription pad.  No need to listen to the other side, no need to be empathetic or open to other views, just pull out your prescription pad, scribble out your note, proclaim it loudly, ignore any dissent and move on to the next patient.

It’s easy for me to see how Dr. Krauthammer moved from writing prescriptions to climbing on his commentator soap box and shouting out his rhetoric.  He is “the Doctor”, and our society is “the patient.”  He will write columns/prescriptions whether they work or whether we listen.  But that is his right, just as it is our right to reject any prescription regardless of what letters follow the person’s name!

Please note it is not my intention to paint all of psychiatry in a negative way.  I have met and worked with many caring, compassionate and dedicated psychiatrists, both foreign and native born. Drug prescriptions have their place in the treatment regiment, but they are not the only or necessarily the best solution to a patient’s problems.

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