Shirah Vollmer MD

The Musings of Dr. Vollmer

Teaching Psychotherapy To Psychiatrists: Is The Teaching Art Still Viable?

Posted by Dr. Vollmer on June 11, 2013

Well, the journey of teaching psychotherapy, like doing psychotherapy is nonlinear. “How do we know if we are doing any good?” One student asks. That, of course, is always a question. Who decides if the process is going well? The patient, the therapist, a joint construct? “When do you decide to terminate?” Again, whose decision is this? All of these questions are unknowable and unique to the doctor/patient dyad. “You need to read about theories of the mind,” I say, “that is the most important thing.” Reading about theory is not part of the curriculum, and yet, although I know that, I feel stunned. Without a broad base of understanding about human motivation, listening can be an agonizing experience of repetition and confusion. Without a theory, one approaches psychotherapy without the way of listening which promotes deep understanding of issues like transference, projection and displacement. I cannot imagine learning psychotherapy without a long syllabus, comparing and contrasting our great thought leaders. Just the idea of a syllabus is often a novelty, leaving me stunned, yet again. Of course, some folks are driven to read, as it captures their imagination, but I am wondering why this is not required. Of course, I know that in this era of neurobiology, which I also love, reading theory seems to have fallen away. Maybe the inmates will run the asylum and bring the vast library back to training. In this case, I hope the inmates win.

4 Responses to “Teaching Psychotherapy To Psychiatrists: Is The Teaching Art Still Viable?”

  1. Jon said

    Without a model of the mind – a theory of the mind – I don’t see how a budding psychotherapist could function. A session would be a conversation being effectively many data points – many dots. Theory is that which organizes the data into a sensible whole – the connecting of the dots. It is sadly amazing that the curriculum of modern psychiatric training has this lacuna, this missing piece. Be it Freud, Jung, or any of the great successor or predecessors who thought of how the mind works, one must start with some model and see how it fits with the realities that are encountered. The more one has read, the more one might be able to successfully connect the dots.

  2. Shelly said

    Has it ever happened, in your experience, that you’ve said to a patient, “I think it’s time to end our sessions? We’ve worked out all your demons, talked about all your issues, explored everything we possibly could together and it’s time to go.” Seriously. Does that happen? Why do I get the feeling that a patient is usually the one who decides to end therapy, for a variety of reasons?

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