What is your gripe with Psychology/Psychiatry? -Ask the Clinical Psychologist

Anaxagoras

*Disclaimer*

I am not state licensed and therefore I do not currently practice in my state which means that if you are inquiring about some psychological distress either yourself or someone else, or inquiring about what medication to take, or which medication is too much or what you require, or if you are suffering from a psychotic episode I implore you to either seek immediate medical/psychiatric assistance and/or consult with your primary physician and/or psychiatrist.

My current background is that I have a doctorate degree in Clinical Psychology. I did four years of undergraduate work at a Cal-State institution, was in the psychology club there and conducted various research (most notable research I've done on HIV/AIDS knowledge among sexually active college students). After that, I did 6 years of doctoral studies, two and a half years of that spent obtaining my masters degree in Clinical Psychology, the additional four years was my doctoral work. I did my dissertation on the behavioral and diagnostic criteria of frontotemporal dementia.

After doctoral work, I did my residency at a local Los Angeles hospital. Shortly after I was burnt out doing research and my residency and therefore had a mental breakdown due to some family deaths so I chose not to go through my licensure. After some years on my academic hiatus, I decided to go back to school to obtain my second masters degree but this time in social work. I'm currently in the process of receiving licensure in my state for social work. Like my real name, I prefer to keep the universities I've attended and my hospitals anonymous. If you absolutely have to know the universities I've attended just PM me.

But more importantly this thread isn't about "who is Anaxagoras?" (He is a philosopher whom you can google to know more) Rather, this is about my concern for some of you and your issue with the profession of psychology/psychiatry?

A few things to consider before you respond regarding psychology/psychiatry. The one thing to know is psychology is about the scientific study of the mind and behavior. Psychiatry is about the study and treatment of mental illness, emotional distress, and abnormal behavior. The former is academic which requires four years of doctoral study followed by a two year residency. The latter, requires medical school followed by two years of residency. Psychologists in the United States cannot prescribe medication except in a few states. Psychiatrists can prescribe medication as well as offer some behavioral therapy techniques which of course for insurance purposes may be a lot more expensive.

A daily routine for many psychologists is mainly about examining neurological/behavioral disorders which has affected a persons day to day activities. So, with all that being said, for those of you that have issues, what is the dang problem with our profession?

↪Anaxagoras

Awesome! Do you think it helps you a lot in philosophy and philosophical discussions, like you've gained an insight which others without your qualifications lack? I'm the very opposite of having a gripe, so I realise that I'm not your intended audience. But I'm interested and curious.

I very much wanted to go to college to study psychology, but I was eventually dissuaded from doing so.

ArguingWAristotleTiff

So, with all that being said, for those of you that have issues, what is the dang problem with our profession? — Anaxagoras

The problem I have seen is the decrease in effectively listening to the person/patient AND the person/patient losing trust with their Doctor.

Too many times situational stress/depression are under considerded and revisiting getting off a treatment plan with medication is dismissed.

Keeping people/patients on medications for life may be appropriate for some, dare I even say a few but that is not necessary for all.

People/patients seek a solution, if it's in pill form, it's got to work! Doctors see (acknowledged or denied) solutions in pill form that the patient believes in more than themselves and we are off to the races. The lifelong race that has very few offramps, rarely suggested by the Doc to even entertain getting off the medications that once were appropriate but years later might not be necessary. But Doctors rarely seek to get their patients off of medications. Maybe you can say why that is.

leo

As I hinted in other threads, the main problem I see is that psychiatry is focused on making people adapt to the system they live in, and assumes that if they don't adapt well, if they suffer, then there is something wrong in their brain, an illness to cure.

It used to be a mental illness to be a slave and wanting to escape, because a well-adapted slave doesn't want to escape. The problem was found in the individual rather than in the system imposed on the individual, slavery.

It used to be a mental illness to be a homosexual, because a well-adapted human being isn't sexually attracted to individuals of the same sex. The problem was found in the individual rather than in the social norms imposed on the individual.

Now, if you're not well-adapted to spending 2 hours in traffic and sitting 9 hours in a cubicle doing a repetitive task while being pressured by superiors to reach productivity goals, 5 days a week, 50 weeks a year, and you're stressed or depressed or lash out as a result, it's because you have a mental illness, something wrong in your brain. The problem is found in the individual rather than in the constraints that the individual is made to endure.

These examples show that psychiatry has more to do with ensuring that people conform to the constraints and norms imposed onto them, than with having the well-being of people as its top priority.

Is it then a wonder that despite all the resources spent on psychiatry, more and more people are diagnosed as mentally ill, and more and more people kill themselves every year?

Anaxagoras

Do you think it helps you a lot in philosophy and philosophical discussions, like you've gained an insight which others without your qualifications lack? — S

Well I've always had a background in philosophy. My first serious paper was me arguing against Peter Abelard's trinity argument. Philosophy does make people mad though. But philosophy provides an understanding of how to construct and deconstruct arguments. The problem with what I see in modern philosophy is that it invites people with psychological issues.

I very much wanted to go to college to study psychology, but I was eventually dissuaded from doing so. — S

Why?

Anaxagoras

The problem I have seen is the decrease in effectively listening to the person/patient AND the person/patient losing trust with their Doctor. — ArguingWAristotleTiff

That is understandable, and that happens a lot unfortunately. I believe a lot of psychologist move away from the humane perspective and look at people as merely clients. Although we are taught to move away as referencing people as patients to clients, psychologists nowadays still look at our clients still as patients.

Too many times situational stress/depression are under considerded and revisiting getting off a treatment plan with medication is dismissed. — ArguingWAristotleTiff

I agree.

Keeping people/patients on medications for life may be appropriate for some, dare I even say a few but that is not necessary for all. — ArguingWAristotleTiff

Which is why I'm an advocate of both medication as well as behavioral therapy. I believe in modifying the problem using coping skills that are taught out to out emphasize medication. However, this is not equal for all people. Neurologically some people unfortunately will need meds for the rest of their lives. Not because of some phantom dependency but because they are symptomatic to the U.S. class system. Some people are developmentally delayed and require it, and some aren't.

People/patients seek a solution, if it's in pill form — ArguingWAristotleTiff

I personally think that's the problem. Do you take a pill every night for sleep? Do you need a pill to help your body to sleep? No, your braid naturally does that for you. Those that need sleep aids often are affected by something that interferes that process, whether it is alcoholism, drugs, stress, work. But if we can use sleep aid and a way in how to help someone schedule themselves in reformatting their sleep habits the habits alone can do away with "pill dependency."

But Doctors rarely seek to get their patients off of medications. Maybe you can say why that is. — ArguingWAristotleTiff

I think this is untrue. Well, let me rephrase, I'd like to believe this is untrue. I believe the unfortunate misnomer about psychologists/psychiatrists I see is that this profession is seen as just pill distributers. Unfortunately, psychologists/psychiatrists don't run from the same playbook except the DSM or Diagnostic Statistical Manual. With that being said I cannot say with confidence going to one professional means you'll seek the correct treatment as everyone has an idea of how to help someone. You have to remember, a lot of these professionals see so many patients losing the one-to-one mentality is most of the time lost. I like to believe everyone in the world has mental issues because humankind is bombarded so much with stress and biological deficiencies.

Anaxagoras

psychiatry is focused on making people adapt to the system they live in, and assumes that if they don't adapt well, if they suffer, then there is something wrong in their brain, an illness to cure. — leo

As I've stated in the beginning psychiatrists are different than psychologists, we use the same playbook, but unfortunately we run different plays. Psychiatrists are mainly focusing on medication management. They see a neurological problem followed by maladaptive behavior, they try to mitigate that with medication. Some offer behavioral modification in addition to the medication but all are not the same and the results are always not the same. Psychologists deal with behavioral therapy and instill coping mechanisms in our clients.

Let me say first hand that every professionals intent is to try and help people, but the unfortunate part about helping people is that it does not always work. In addition to that is there are sometimes too many clients to one person, and therefore if a psychiatrist is not helping you, perhaps you may need to seek a psychologist to manage your behavior. But yes, at the end of the day, sometimes medication is not always the answer.

Shawn

I think I can only talk about the American system; but, the profit motive has driven a wedge between psychiatrists with their free trial Rexulti or Latuda, and the hard-working psychoanalyst that gets no freebies from big pharma due to not being able to prescribe them.

I like sushi

What would you say is a good minimum age to be a clinical psychologist?

Anaxagoras

What would you say is a good minimum age to be a clinical psychologist? — I like sushi

This is contrary to the subject at hand but nevertheless I'll answer that......

Well, it depends on the person really. There is no specific age really because the academic portion itself can be completed whenever, provided that you can get into a doctoral program to begin with. Not to mention the amount of time it takes to complete (roughly six to eight years is the median range of years it takes to complete). So theoretically based on time, the amount of school work hours and time the best age to pursue doctoral studies would be in the early twenties. I'd say after you're done getting your undergraduate degree.

Anaxagoras

I think I can only talk about the American system; but, the profit motive has driven a wedge between psychiatrists with their free trial Rexulti or Latuda, and the hard-working psychoanalyst that gets no freebies from big pharma due to not being able to prescribe them. — Wallows

Right and this is perennial issue that we constantly debate with psychiatrists about this very issue that you're talking about. Funny that you mentioned this because I was reading an old article discussing this:

"The move to grant psychologists prescriptive authority, Sammons said,“ takes place in the context of a vast transformation in American health care, an extraordinary rate of change in the scope of practice of any nonphysician provider.”

Sammons went on to note that “our mental health system, as Dr. Steckler will talk about in a few moments, is so badly broken. We believe that prescriptive authority will help to rectify this really tragic situation for many Americans.”

Source:https://psychnews.psychiatryonline.org/doi/full/10.1176/pn.39.15.0390008

I like sushi

As I've stated in the beginning psychiatrists are different than psychologists, we use the same playbook, but unfortunately we run different plays. Psychiatrists are mainly focusing on medication management. They see a neurological problem followed by maladaptive behavior, they try to mitigate that with medication. Some offer behavioral modification in addition to the medication but all are not the same and the results are always not the same. Psychologists deal with behavioral therapy and instill coping mechanisms in our clients. — Anaxagoras

This is what concerns me. I wouldn’t call it a “gripe” exactly, but I do sometimes get the impression that the “psychologist” and “psychiatrist” may devalue each other? You’ve got experience in the field , what would you say?

Note: Anecdotal this may be a student I met wanted to become a psychologist yet her lecturer told her that it wasn’t worth it because there was no demand for psychologists and that it was effectively a “dying regime”. Of course he may not be a common case, yet I’ve heard of psychiatrist with some questionable attitudes - meaning they were focused on applying medication to the patient rather than asking any serious questions.

Anaxagoras

This is what concerns me. I wouldn’t call it a “gripe” exactly, but I do sometimes get the impression that the “psychologist” and “psychiatrist” may devalue each other? You’ve got experience in the field , what would you say? — I like sushi

I don't believe we "devalue each other." It's two professions with minor distinctions trying to treat the same issue. We're all colleagues really and that is the important part. I believe the crux of the hubris among the psychologists and psychiatrists usually stems from within the psychology community between PHD and those with PsyD. Some in the PHD community still believe having a PsyD means you didn't do real research or what not. But this is more along the lines of like the U.S. military branches and how they have sarcastic names for each other really.

Note: Anecdotal this may be a student I met wanted to become a psychologist yet her lecturer told her that it wasn’t worth it because there was no demand for psychologists and that it was effectively a “dying regime”. Of course he may not be a common case, yet I’ve heard of psychiatrist with some questionable attitudes - meaning they were focused on applying medication to the patient rather than asking any serious questions. — I like sushi

Well let me say that a lecturer is not an authority over someone's life. What a person does is what they choose to do because it is their life and their choice. Some professors may impart an opinion but it doesn't mean their worldview is law. Mental Health is always in need of psychologists and psychiatrists. So long as human beings exist and live in a world bombarded by stress, anxiety, social issues, world issues, environmental issues, and demons (of course in the literal and metaphorical sense), we'll always need mental health professionals.

Shawn

"The move to grant psychologists prescriptive authority, Sammons said,“ takes place in the context of a vast transformation in American health care, an extraordinary rate of change in the scope of practice of any nonphysician provider.”

Sammons went on to note that “our mental health system, as Dr. Steckler will talk about in a few moments, is so badly broken. We believe that prescriptive authority will help to rectify this really tragic situation for many Americans.” — Anaxagoras

Awesome. I don't want to fork out 500 USD for an initial visit and then pay 100 for prescription refills from a defunct system.

Hope this gets done.

Shawn

I bet the AMA will go batshit over this proposal.

yupamiralda

So, you're saying you paid a lot of money so that you can claim you are an "expert"?

whollyrolling

I have a question, why are clinical psychologists/psychiatrists such failures at compassion and generally failures as human beings with more mental issues than the patients they treat, and why are they so arrogant while simultaneously so confused about the nature of their profession?

Present company excluded, of course.

Anaxagoras

So, you're saying you paid a lot of money so that you can claim you are an "expert"? — yupamiralda

No. I actually gave a decent brief description of my background in the beginning, failure to read it may be due to a lack of not utilizing the complete function of your frontal lobe.

Anaxagoras

I have a question, why are clinical psychologists/psychiatrists such failures at compassion and generally failures as human beings with more mental issues than the patients they treat, and why are they so arrogant while simultaneously so confused about the nature of their profession? — whollyrolling

I'm not sure, but it sounds like you're generalizing quite a bit. That is a lot of people to put in one category. Clinical professionals are as diverse like any other professional who practices. Which is why I encourage people who have issues with therapists to go and get another one. Unfortunately, some people's experiences are so bad that one experience may keep someone from getting another therapist. So I cannot speak for the thousands of clinicians in the world.

yupamiralda

↪Anaxagoras

I've just seen a lot of folks in the mental health field hide behind their credentials when they can't answer a question.

Anaxagoras

I've just seen a lot of folks in the mental health field hide behind their credentials when they can't answer a question. — yupamiralda

Well it depends on how the question is framed. If you're looking for an answer to which it may be complex, you'll be disappointed. That is like someone asking me how long am I supposed to take atvian for my panic attacks? Most common response among practitioners would be as needed.

yupamiralda

↪Anaxagoras

It's been a while since I've questioned my treatment....I've found that what they want is basically utter submission. Basically every decision I make is judged according to a "medication working/medication not working" binary. I used to protest that the contents of my thoughts made a difference (they have changed quite a bit) but basically it's a moot point. During periods where I was fighting with my doctors I have been off all meds for months and they weren't able to get an order to forcibly medicate because I was presenting no symptoms. And just general things about how little information they use to diagnose and prescribe and things like that. I've been in the system 9 years and it's totally ridiculous. I don't really care anymore, and anyway, the point seems not to help people but rather either imprison them or mark them for increased government attention. That would happen with some system even if it wasn't mental health--the public wants certain people removed from society. And just about everybody I'm locked up with, I don't disagree with the idea of locking them up. I think the whole enterprise is of limited scientific validity (although not none) and it's being pressed into the service of public order. But I don't say anything about it, because questioning the system in any way is "symptomatic" or "delusional".

Anaxagoras

I've found that what they want is basically utter submission — yupamiralda

To what?

Basically every decision I make is judged according to a "medication working/medication not working" binary. — yupamiralda

If your behavior is maladaptive do you wish for them to say nothing?

In addition to everything else you have said you have to understand that there are clients I've seen that had grandiose thinking in which they believe they don't need medication but obviously because of their history and the present symptom of grandiose thinking they may do things that may not produce the desired result. But the thing is I cannot give an objective opinion because I don't know you. But you must understand that there are people with psychological conditions that do try and convince therapists they are well and they aren't. Maybe that is why you come into conflict with them, however that is not me saying you aren't/weren't well.

Shawn

Given your experience with the whole industry of antidepressants and the obsession with magical, fast acting, immediate relief inherent biases out of the way, when do you think as a psychologist will the American system start treating (or catch up with places like Cambodia) where, mental health as a social issue?

yupamiralda

↪Anaxagoras

Utter submission to the authorities running the mental health system, from doctors to orderlies. If I, as a mental health patient, have a problem with the authorities, I am a priori wrong.

I'm just locked up because I was violently mentally ill over a decade ago. It doesn't matter how stable I am, the state sees me as a liability and they will never unilaterally recommend my release. I have a lawyer working on it.

I'm quite sure many of the decisions made in the mental health system similarly have nothing to do with mental illness but rather of control.

And I mean, I know what you're talking about with people who seem normal but are nursing some, say, religious interpretation of psychosis.

Shawn

I'm just locked up because I was violently mentally ill over a decade ago. It doesn't matter how stable I am, the state sees me as a liability and they will never unilaterally recommend my release. I have a lawyer working on it. — yupamiralda

Wow, how bad is it?

yupamiralda

↪Wallows

Hopefully by the end of the year he'll put in a challenge and get an independent doc to check me out. I think my odds are pretty good; no violence in 12 years unless you count defending mental health workers, which there's probably no record of. I've got some black marks for more or less serious mischief (sneaking into offices to use the internet, getting buzzed on hand sanitizer) but if the question is: "is he dangerous to himself or others?" I think it might work out.

Shawn

↪yupamiralda

I don't know your diagnosis or what landed you in a state institution, but you come off as a sane person.

Hope things work out for you.

Pattern-chaser

what is the dang problem with our profession? — Anaxagoras

That it pretends to be a science. The study of humans, especially their minds, needs to account for things that science cannot describe or deal with. It's too important to be disabled by the pretence of being a science, as though that was a distinction worth seeking out.

deletedusercb

So, with all that being said, for those of you that have issues, what is the dang problem with our profession? — Anaxagoras

There is a marketing approach from pharma that leads to new diagnoses with the first and strong motivation in creating new markets. This is not remotely criticized enough by psychiatry or even psychologists. And many of the former participate in this.

There is a pathologization of individual response to a variety of traumas and stress, where their brains are considered to have chemical imbalances which need to be adjusted with chemical treatments. Rather than normal until proven abnormal - a little bit in the sense of in law with innocent - we have deviation from hypothetical norms indicates brain abnormalities.

They hand out a tremendous amount of, for example. anti-depressives, effectively cutting off a feedback on both the individual and general levels about quality of life. Instead of perhaps questioning the external factors we cut off the feedback, similar to giving pain killers to people with a variety of issues: broken legs, infections, whatever (and we also do this with over the counter pills to drop fevers that are part of our immune reaction and no one seems to say much about this, but that's another issue with similar roots).

That's a start.

And note: this is primarily to do with phychiatry from the thread title, and much less to do with clinical psychologists.

What is your gripe with Psychology/Psychiatry? -Ask the Clinical Psychologist

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