I was trained at a time when the psychiatrist’s role was undergoing a profound change. During my residency all but one of us residents considered our own individual psychological treatment (for which we paid out of pocket) was essential to becoming competent practitioners. Included in our training was weekly group therapy on the ward run by a psychologist specially trained in group therapy.
Since then, the field has shifted dramatically. Psychiatrists are rarely acknowledged as psychotherapists today. Indeed, younger psychiatrists have had a very different kind of training than those of us in earlier generations. With the entrance of psychologists and social workers into the field, our task has narrowed, often reduced to that of psychopharmacologist.
At times, when I attempt to gather a complete picture of a person’s life, as I believe is my responsibility, some clients seem reluctant to share, thinking that I am trespassing on the turf of their psychotherapist. Their demeanor seems to signal that they want me to get on with the task: JUST PRESCRIBE.
I have no problem prescribing an appropriate medication, but I do find that if I limit the task, the pleasure is diminished, as if the sap has dried up in an old fruit. The delight returns when treating the rare person who has sought me out precisely because of my background in psychodynamic psychotherapy.
While I continue to work with a limited number of individuals, I’m devoting more of my time to my newer identity as a poet. I hope you will follow me at my Substack, Poet Lair.
Thank you, Dear Readers.
