It seems that practically every person who comes in for treatment has a different idea of what constitutes psychiatry and what they should expect when seeing a psychiatrist.
Many stereotypical impressions of psychiatry arise out of television shows or books. In these stories, patients are portrayed lying prostrate on a couch, delving into the deep recesses of their childhood memories to discover why they have a problem with anxiety or binge eating in their present life.
While childhood experiences are sometimes important in psychiatric treatment, this method is definitely not the mainstay of the profession and the couch is out.
A lot of people are unsure what the difference is between a psychiatrist and a psychologist. Often, the two terms are used interchangeably, but they imply two very different professions.
A psychiatrist is a medical doctor. Every psychiatrist has gone through the same medical school training as a family doctor or heart surgeon, but has chosen to specialize in mental illness rather than surgery or general practice. This medical background helps the psychiatrist to understand the biological underpinnings of psychological disorders. Unlike psychologists, a psychiatrist can prescribe medication to treat mental disorders.
This is an important distinction because, while psychologists can be very beneficial and counselling is often an important part of treatment, some severe psychiatric illnesses such as schizophrenia or bipolar disorder cannot be effectively managed with talk therapy alone.
Also, psychiatric treatment is covered by Canada’s healthcare system and visits are paid for through an individual’s basic provincial medical services plan. This means that, even without extended medical coverage, a person can see a psychiatrist and receive treatment for a mental illness. There are no limits to the number of sessions per year or the number of years of therapy, as some of these illnesses are life-long.
A referral to a psychiatrist by your family doctor is necessary in order to qualify for MSP coverage.
Even when medications are used, there are other facets to treatment in almost every case. First and foremost is education. Giving information about the disorder and why it has occurred is a crucial first step. There may be genetic predispositions, environmental contributions, or both as is usually the case. Providing education about the treatment is also important – why it is recommended and how it will work to alleviate the problem. In some cases no medication is necessary and instead it will be important to identify real life problems and how to work to solve them.
Contrary to popular characterization, a visit to a psychiatrist should involve more than passive listening on the part of the doctor. Following a diagnosis and education about your disorder, your doctor should discuss your treatment goals with you, explain the technique behind your treatment and give you specific activities to work on between sessions. The psychiatrist should be supportive, giving real advice and guidelines while encouraging you to be independent in your actions and opinions.
Each session should have a specific focus and centre on themes such as ideas or belief systems. An effective therapist will be confident and self-assured and will structure the session – introducing new topics and seeking more information or elaboration from you as well as presenting things in a new or different light.
As medical knowledge improves, it becomes easier to treat mental illnesses. This is a quickly advancing field and many effective treatments are now available. The information outlined in this column may help to minimize some of the misconceptions about seeking psychiatric help.
Dr. Latimer is president of Okanagan Clinical Trials and an Okanagan psychiatrist.
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