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Wednesday, February 20, 2008

Psychiatric Residents in Psychotherapy

During your residency in psychiatry in The Netherlands you have to have at least 50 sessions of psychotherapy. This is done for several reasons.

The first one is of course the notion that in performing psychotherapy, the relationship is the very instrument of the treatment. Residents in psychiatry should be aware of their own feelings about their patients — a process called countertransference.

Another advantage is the awareness of what it means to be in psychotherapy for a patient. And sometimes residents can benefit from the treatment of their own complaints. Sometimes this therapy is useful for their own complaints and can be followed by further psychotherapy.

But this privilege is under attack by more neuroscience oriented Heads of Departments of Psychiatry in The Netherlands.

That is why I fully endorse the statement made in a recent article in the New York Times: ‘Have You Ever Been in Psychotherapy, Doctor?’

But even as we have been swept off our feet by sexy neuroscience, my field is in danger of losing touch with the rich psychological life of patients, something that is reflected in the waning popularity of therapy during residency training.

And this one
We can effectively relieve symptoms and increase functioning, but we still have to help our patients live with illness.

Psychiatry or medicine is not only knowledge but also an art.


Aqua said...

What a great post. I think what psychiatrists forget sometimes is that sometimes medication can do nothing to relieve the symptoms and functioning for a patient. I know from experience in therapy with my psychiatrist that the therapy we do together is what keeps me trying. I think therapy is essential to psychiatry.

In Canada psychiatry is focusing so much on biomedical/biological causes, cures and relief that they have forgotten that people also need good roles models and need someone to help them heal, especially if the medication does not help them.

I believe all psychiatrists should go through therapy. I think it allows the doctor to have a better understanding of the process and the importance of this type of treatment.

Thank god I met a pdoc who practices both therapy and offers medication strategies. I can honestly say without the therapy I would never have survived this depression.

Anonymous said...

Something else that is interesting,
in a post at mindhacks
the blogger discusses the fact that researchers have shown that the the rate of mental illness in female psychiatrists is almost twice the rate of other doctors. So it seems that psychotherapy sessions could help a psychiatrist improve their own mental health, in addition to helping them understand their patient's condition.

Dr. Shock said...

@Aqua That's number 101 ;)
We even have trouble finding supervisors for the psychotherapy course our residents have to take before ending their training to become a psychiatrist.
We used to have a broad staff with a wide range of knowledge and expertise, now it is all research and neuropsychiatry.
Regards Dr Shock