Table of contents
- Who should I go to for treatment?
- Psychologist
- Psychotherapist
- Psychiatrist
- Neurologist and neuropathologist
God forbid I go crazy, no, better than a staff and a scrip... These words were written by the great poet Alexander Pushkin almost two centuries ago, but they remain relevant for most of us even now. Indeed, many of us fear mental illnesses much more than physical illnesses.
And this is the main reason why treatment or correction of mental disorders begins late. What keeps a person from seeing a doctor in a timely manner is the fear of being labeled as “mentally ill.”
But there is another problem: often people simply do not know which doctor to contact if certain symptoms of mental disorder occur. Psychologist, psychotherapist, psychiatrist - the prefix “psycho” is perceived as an intimidating factor, and creates the misleading impression that all these specialists are doing the same thing. But there are also neurologists (neuropathologists) - in what area do they work?
Areas of knowledge
The first and most important thing in which they differ is the field of knowledge in which each of them is [under a successful combination of circumstances] a specialist. So, psychiatry. Firstly, it is part of medicine. Those. areas of knowledge and industry dedicated to diseases and their treatment, prevention, prevention and rehabilitation after. Psychiatry studies various types of mental disorders. She doesn't deal with the norm. Or rather, not like that: she deals with her in the sense that she tries to bring her patients to her, but if a person is mentally healthy and does not intend to lose this status, then she most likely will not be interested in him. Psychology is almost the complete opposite. Firstly, this is not a branch of medicine (yes, there is so-called medical psychology, but more about it below and separately). She studies the work of the psyche. A normal healthy psyche, for the most part (again, yes, there is pathopsychology, but we will also consider it separately). Those. For her, a healthy person, rejected by psychiatry because of his normality, will be interesting in practical and theoretical terms. But psychology does not deal with treatment. But he is engaged in increasing the level of adaptation, personal effectiveness, personal growth and other similar things. Psychotherapy. This is also part of medicine. In the sense that it considers, studies and practices the treatment of mental illness. But, at the same time, she can also deal with the normalization / solution of the problems of a healthy person. Those. in the field of problems being solved, this is a mixture of psychiatry and psychology.
Psychotherapist
Profile
. A doctor with a medical education who has experience as a psychiatrist.
What diseases does he specialize in?
A psychotherapist can help with almost all diseases of the nervous system. In addition to severe ones, such as psychosis, epilepsy, severe mental retardation, suicidal behavior. He treats people with mental disorders and provides assistance in difficult psychological conditions. Treats mild and moderate forms of neuroses, psychoses, paranoia, panic attacks, phobias, panic conditions, chronic fatigue syndrome and other pathologies.
What methods does it use?
As a doctor, he can use any treatment methods: medication, physiotherapy, exercise therapy. etc. But the main method of work of a psychotherapist is psychotherapy. Eliminates the patient's problem with the help of psychotherapy, including psychoanalysis, existential psychotherapy, Gestalt therapy, family therapy, hypnosis, etc.. Can prescribe antidepressants, sedatives, sedatives that complement the effect of psychotherapy.
Psychotherapists at the ROSA clinic:
Filashikhin Vyacheslav Vyacheslavovich, Makarenkov Evgeniy Vladimirovich, Artemov Alexander Pavlovich.
Specialist education
A psychiatrist and psychotherapist are always specialists with higher specialized education. A psychologist (but not a medical psychologist) can (at least at the time of writing this post, until the law on providing psychological assistance has been adopted) be a person who has no formal education at all. Further, a psychiatrist and psychotherapist are doctors. Those. these are people who graduated from the Faculty of Medicine, completed residency/internship/practice as a GP/other formal stages - depending on how long the specialist’s training took: lately, officials like to change this medical bureaucracy quite often. An ordinary psychologist may not do any of this. There are psychologists with higher psychological education. And there are without it, but past profs. retraining or training at some MAAP or Gestalt institute. Those. formally this is not a higher education, but studying there is also long, expensive and very hardcore. A psychiatrist, psychotherapist and medical psychologist (but not just a psychologist, this does not apply to him) must undergo training and advanced training, otherwise their diploma / license loses its validity. Only a person who is already a psychiatrist (but not a psychologist!) can become a psychotherapist through additional training. After this, he receives the appropriate certificate and the right to be called a psychotherapist. You can retrain to become a psychologist relatively quickly (no more than 1,100 hours) and cheaply (from 15,000 rubles). Even clinical/medical (it's the same thing). This is done through professional retraining, on the basis of which a diploma is then awarded with a qualification. But there is no particular point in this - on the one hand, private practice can be conducted without a diploma at all, on the other, if the employer requires a higher education, then, most likely, a retraining diploma will not suit him. But, as I already said, this is not how you become a real clinical psychologist. What is the difference between real and fake? Because the real one has the right to work in a mental hospital, but the fake one does not. At the same time, he can work in the Ministry of Internal Affairs, the army, or a regular hospital, but not in a psychiatric hospital. There is an opinion that you can turn out and become a real clinical psychologist without first studying for it, if you get a higher education in psychology and then undergo retraining for clinical psychology (or graduate from the medical department and then retrain for clinical psychology), but I was not able to find out the reliability of this information . In different educational organizations and psychiatric hospitals I was given different answers.
Psychiatrist
A psychiatrist is a doctor with higher education and a certificate in the specialty of psychiatry. Such a specialist has the right to treat both severe mental disorders and transient conditions, such as depression. He may prescribe medications, conduct formal examinations, and provide opinions on the patient's mental health and capacity.
You should contact a psychiatrist if you have suicidal thoughts or intentions, hallucinations, severe anxiety, sleep disturbances, sudden uncontrollable mood swings, strange or grandiose “ideas,” inability to cope with current daily tasks, or prolonged depression in mood.
Drug therapy
A psychologist does not write out or prescribe funny pills. And sad ones too. Even medical. If he recommends accepting something, then he goes beyond his formal rights. In current realities, this does not mean that he is necessarily wrong, but you must understand that he is exceeding his authority. On the contrary, both a psychiatrist and a psychotherapist have the right to prescribe pills. In practice, the former, as a rule, limit themselves to only this, while the latter often refuse this opportunity, preferring treatment with words. On the other hand, both a psychiatrist and a psychotherapist have the right to use non-drug methods of influence (the same therapeutic conversations in all their diversity).
Don't be afraid of visiting a psychiatrist
Whatever it is, you shouldn’t let prejudices ruin your health. Today, psychiatry has made a qualitative step forward and it is possible to solve a problem that has been looming for years in a fairly short time. Otherwise, you will have to wait for complications in the form of serious psychopathologies. In the West, turning to a psychiatrist is not considered a shame; on the contrary, people strive to get rid of mental disorders in order to improve their lives. If the disease does not cause harm to others, the doctor will suggest the most harmless method of treatment.
Practical approach to work
In reality, things are often not as they really are. Therefore, there are no clear rules here, and everything very much depends on the specialist: I have seen psychologists illegally recommending drugs (very competently and successfully), and psychiatrists conducting openly psychotherapeutic sessions (which, in theory, is also haram), and psychotherapists refusing to combine psychiatry with pills. But these are exceptions, and we will look at the general trend. The psychiatrist will most likely feed you pills, give you injections and give you IVs. In most cases, he frankly doesn’t care about your rich inner world, he is interested in the absence of productive (delusions, hallucinations) and (less often) negative (emotional-volitional defect) symptoms. How well (subjectively) you will feel after life-giving haloperidol is of no concern to him (of course, there are good specialists who do not, but in my provincial sample there are vanishingly few of them). The psychologist will most likely talk to you. Ask something about your childhood, analyze your thoughts, feelings and somehow interpret them. In principle, all the psychologists I know (both personally, on the Internet, and in literature) have given up on the ban on engaging in psychotherapy and are actively pursuing it. The only “but” is that en masse they are afraid of real psychos. Those. If a psychologist is able to recognize a schizo, most likely he will refuse to work with him. No, no, if you have OCD, bipolar disorder, autism or something else, you shouldn’t rejoice - usually psychologists don’t really understand the types of psychos and are afraid of everyone the same. A clinical psychologist will work with you to diagnose, test and determine what and who you are. And, of course, psychocounseling. And even psychological correction (see below). And then, quite possibly, he will send you to a psychiatrist, psychologist or psychotherapist with specific recommendations, which can be very useful. A psychotherapist can feed you pills, and then, in fact, work either in the format of psychotherapy (word treatment) or psychology (increasing awareness, helping in self-knowledge and understanding of others). But in practice, they are still either psychiatrists at heart and base treatment on drug therapy, or psychologists (we remember that in reality psychologists do not hesitate to use psychotherapy methods, although, in theory, they should not).
Psychoanalyst
This is a specialist who may be a psychotherapist or a psychologist-psychotherapist. Psychoanalysis
is a well-known technique that has existed for many decades and has long established itself as an absolutely proven technique in both psychiatry and psychology. Modern psychoanalysis can be called an independent discipline, based on the key principles of the architecture of the human psyche, discovered by Sigmund Freud and his followers and based on the theory of the unconscious. Once you see a psychoanalyst, you will have the opportunity to discover a lot of new things in the content of your mental life and direct its course in a direction that is comfortable for you.
Who to go to
To a good specialist. Seriously: a good specialist in the “wrong” (i.e., not the most suitable for your specific case) field is much better than a bad specialist in the right one. Simply because a good psychologist knows a good psychiatrist and will send you to the right address, if suddenly your misunderstanding with your wife is a manifestation of paranoid schiz, and you don’t have any wife. On the other hand, a good psychiatrist will prescribe you ascorbic acid and send you to a psychologist, if you are not a psychotic hypochondriac. But if you don’t know a good shrink, you can use the following diagram as a guide. 1. Go to a psychotherapist or medical (not ordinary!) psychologist. And require him to determine which area your problem belongs to. After this everything will become clear. 2. If this is not possible, and the choice is between a simple psychologist and a psychiatrist, then go to a psychiatrist. Simply because in this case the cost of a mistake is lower: it’s not as scary for a healthy person to take a course of some “Risperidone” as it is for a crazy person with delusions of jealousy to skip treatment and uselessly delve into why his wife doesn’t love him (paranoia is a scary thing!) . Personally, I worked with all these specialists, and ultimately came to the conclusion voiced in the first paragraph of this section.
Symptoms of mental disorder
Like any disease, mental disorder has its own symptoms and treatment methods. To be sure that the time has come to seek help from a psychiatrist, conduct an analysis based on the following signs:
- apathetic mood lasts continuously longer than 14 days
- total laziness
- absent-mindedness
- insomnia
- increased level of anxiety
- irritability, etc.
If everything in life has suddenly become black and white, and more often than not you are on the dark side, then it may make sense to consult a psychiatrist. Especially if you are experiencing obvious mental health problems. Experts recommend sharing your experiences with a loved one, since it is quite difficult to overcome such difficulties alone.
How to understand if a given specialist is good
This section will be pure IMHO. The surest way: study yourself at least at an intermediate level in psychopharmacology, psychiatry, psychotherapy and psychology and talk to a specialist. Long, expensive, high quality. Attention : this method does not work for people with delusional concepts: if your reality testing is seriously impaired, then for you there is only one answer - nothing. If this is not possible, then there are a few simple rules: 1. Your specialist must have at least an approximate idea of what evidence-based medicine is (even if he is just a psychologist), and how his methods are perceived by her. You can quite successfully work with a specialist who uses methods that do not have proven effectiveness (for example, psychoanalysis), but knowledge of what EBM is, why it is needed, why it is important is a certain general cultural level of a specialist, and if it is not there, talk about nothing. 2. Your specialist should not be intimidated by the words Pubmed and Cochrane. It’s even better if he knows what it is and why he needs it (or convincingly prove that he doesn’t need it, although there are possible options here). 3. Your specialist himself undergoes personal therapy. Even if he is a psychiatrist. Personal therapy is an awesome experience that cannot be replaced by anything. 4. Your specialist knows English at a level sufficient to read professional literature. Simply because all the most interesting and new things are published on it (or quickly translated into it), and if a specialist does not speak this language, he will be on the sidelines of progress. Titles, categories, diplomas, studies and the like don’t mean anything. Experience. Experience is a good thing, but it must be properly integrated and interpreted. And it’s not like “the same clinical mistakes repeated for 20 years.” Reviews... You need to be careful with reviews. This is an area where, in addition to the usual “everyone lies” glorified in House, there is also a lack of awareness. And one discreetly positive review from a schizoid can mean more than ten emotionally enthusiastic praises from a hysterical person (or it may not mean that). How to evaluate the quality of reviews? See the first sentence of the section.
Psychologist and psychoanalyst: what is the difference
There is another concept that is still often associated with Western European fashion. This is a psychoanalyst. Who is he and what is the difference between a psychologist and a psychoanalyst? Psychoanalysis is one of the areas of psychotherapy; a psychoanalyst can also call himself a psychoanalytic psychotherapist or psychotherapist-psychoanalyst.
A psychoanalyst is a psychotherapist who uses psychoanalytic methods as a tool. His main idea is that in our psyche, in addition to what we know about ourselves, there is an even larger part that we are not aware of - the Unconscious. The main goal of psychoanalysis is to explore the client’s unconscious and thereby help him understand the causes of his mental problems: unreasonable fears, personality complexes and other obsessive states that interfere with being happy. Using psychoanalytic techniques, the psychoanalyst helps the client become aware of and understand their unconscious motives and better understand themselves.
Despite the fact that a psychoanalyst is not necessarily a medical doctor by training, psychoanalytic methods are sometimes effectively used to overcome borderline conditions, such as phobias and neuroses. It is not for nothing that the founder of this trend in psychology was Sigmund Freud, a psychiatrist and neurologist.
About clinical/medical psychologists
I promised to write about them separately. First of all, they are the same thing. They are called clinical in their diploma, and medical in their work, when they work in a psychiatric hospital. They have some features that ordinary psychologists don’t have (or few of them): 1. They do study psychiatry. And psychotherapy too. 2. They study pathopsychology, so they can work with real psychos. 3. They carry out psychological correction - i.e. recovery using non-drug methods. How is this different from psychotherapy? Basically the name. And, yes, a real clinical psychologist studied in medical school. institute/university, just not at the medical department, but at the clinical psyche.
This article was published in the blog “A Psycho Consultant Writes,” 01/08/17.
Author: ya_schizotypic
