What Am I Worried About?
Posted by Dr. Vollmer on October 20, 2015
I worry that patients are over-medicated. I worry that psychiatrists are no longer interested in psychotherapy. I worry that the reductionistic model of most evidence-based practices, takes away from embracing the complexity of the human mind. I worry that I won’t have colleagues to pass down my patients as the residency training is so different, and in my mind, more limiting than it ever has been. I worry that patients will see themselves as “sick” as opposed to the author of their own existence. I worry that the central theme of self-sabotage will be lost when patients seek the medical model of wanting a pill to end their suffering. I worry that medications, although very useful, will change the empowerment of the individual from active to passive. I worry that antipsychotic medications are too often used for behavioral control, furthering the idea that the patient is “sick” as opposed to helping a patient see how they can get well by changing their interface with the world. I worry that children, with well meaning parents, will come to see themselves as handicapped, when, in fact, their issues have to do with separating from their parents. I enjoy prescribing medication and facilitating the relief of suffering, but to an extreme, this becomes me carrying them through the illness, with little work on the patient’s part. Most of the time, the patient needs to do the bulk of the work, trying to understand how he gets in his own way. By understanding this, he can move forward with a new approach to his world. This is transformative change, so much more meaningful than symptomatic relief. Again, symptomatic relief is important, but only as a first step towards a deeper understanding of their trauma and their subsequent preconceived negative feelings that they place on their world. Mental schemas, or scripts, often get in the way of new experiences, which often come in the form of new relationships within both old and new connections. Improving these connections leads to life satisfaction and fulfillment. That is not complicated. Getting there is the challenge. Psychiatrists, if we are to save my field, need to want to help people towards deeper experiences with themselves and others. If we give that up, we will enact the very problem we aim to solve. We will get in our own way.