Everyone has psychological problems from time to time. Some “I can’t” force themselves to go to work because of a picky boss, some are worried about a conflict with their spouse or children, some suffer from unjustified fears, and some simply want to improve their quality of life, achieve a higher level of harmony in relationships with yourself and others.
Entrusting your soul to a stranger is not so easy, even if this person is a professional with a diploma and work experience. And if you are not sure that you are contacting “the right address,” doubts begin to torment you even more. It is not surprising that the most difficult step is usually choosing the right specialist.
So who should you turn to: a psychologist, a psychotherapist, a psychiatrist? To answer this question, you first need to understand what problems this or that specialist helps with.
Psychiatrist
A psychiatrist is a doctor. He needs to complete 6 years of medical school, then 2 years of residency in order to specialize in a specific discipline, that is, psychiatry. Then you need to pass an exam at the Ministry of Health or an organization specially authorized by the Ministry of Health and receive a specialist certificate.
The area of competence of a psychiatrist is all mental disorders that are reflected in the international classification of diseases in class F: from schizophrenia, mental retardation and manic-depressive psychosis to stuttering, enuresis, developmental disorders and sexual disorders. Any abnormality in a person’s mental state is a reason to contact a psychiatrist.
A psychiatrist is the only specialist with the root “psycho” who has the right to make a diagnosis and prescribe medications. The psychiatrist's treatment strategies include pharmacotherapy (that is, medications) and psychotherapy. Most often, these two methods are combined.
Please note: there is no such profession as “child psychiatrist”, that is, there are no scientific departments that train doctors of this specialization. There are psychiatrists who primarily work with children and psychiatrists who work primarily with adults. In my opinion, this is bad, because working with children has its own characteristics. They manifest themselves in everything from symptoms to the nature of the course of mental disorders. I think it makes sense to create such a specialization. It is no coincidence that in 1931 the USSR invented the profession of “pediatrician” specifically for general practitioners who care for children. Experience has shown that this is reasonable.
Results: what is the difference between a psychiatrist and a psychotherapist and a psychologist?
Let's compare one by one how they differ from each other.
Firstly, what is the difference between a psychologist and a psychotherapist?
These specialists have different educational backgrounds. In the first case - social and pedagogical education, in the second - medical.
1 — A psychologist works with healthy people, helping them cope with specific situations, make choices, establish relationships with themselves and loved ones, and increase self-esteem. For this purpose, he conducts consultations, trainings, and testing.
2 — A psychotherapist works with borderline states that are recognized by a person, but are a violation. As a rule, these are neuroses (obsessive-compulsive disorders, phobias, psychosomatics - here is our article about how the internal state supports chronic diseases).
He uses individual or group psychotherapy sessions. Therapy can have such varieties as hypnosis, gestalt, art therapy.
Secondly, what is the difference between a psychiatrist and a psychotherapist?
1 — We have already mentioned the psychotherapist.
2 — A psychiatrist treats diseases associated with impaired brain function. He is treated with medication. However, he does not use psychotherapy.
Usually this doctor does not find out what caused the nervous breakdown and psychosis. It is important for him to correctly detect the disease and cope with its symptoms with medication.
At the same time, treatment can be very effective, and it is precisely this that allows one to cope with the patient’s disorders 100%.
Some doctors may also collaborate with a psychotherapist if they consider it necessary.
Psychiatrists themselves can also turn to psychotherapists, because working with mentally ill people is difficult and requires internal study.
So, the difference: a psychotherapist and a psychiatrist : the first works with healthy people with the help of psychotherapy, the second works with patients (who have a problem with their brain function); psychologist and psychotherapist - one helps with improving a person’s adaptation to the outside world, the other with borderline conditions that are expressed in neuroses.
We hope we have answered this question thoroughly. This is the difference between a psychiatrist and a psychotherapist and a psychologist.
Many people still have certain stereotypes associated with these professions.
But there is nothing shameful about mental and brain disorders. They, just like other violations, can be corrected and improved.
At the same time, even turning to a psychiatrist, this does not threaten dispensary registration. Therefore, there is no need to be afraid of him!
Psychotherapist
Only a doctor can be a psychotherapist. People of other specialties who practice psychotherapy are subject to the Criminal Code for illegal healing. By definition, psychotherapy is a non-drug therapeutic method. Like surgery, for example. Only there is a scalpel, and here is a word. But words are different, therefore, a person without a medical education, engaged in medical activities, violates the law.
A doctor of any specialty can become a psychotherapist. To do this, a psychiatrist needs to study for six months. Another doctor takes two years (to master psychiatry). At the end of the course, after successfully passing the exams, the doctor receives a certificate as a psychotherapist.
Why so many precautions if psychotherapy does not involve medications? The fact is that this treatment strategy has its own indications and contraindications. The psychotherapist must clearly understand what kind of mental disorder the patient has before starting treatment. For example, hypnosis of a patient with schizophrenia is usually dangerous both for himself and for the doctor and the patient’s environment. Such patients need other methods: body-oriented therapy, drama therapy, etc.
Sometimes mental illnesses occur due to organic lesions of the brain. A person without medical education (for example, a psychologist) can engage in psychotherapy for a very long time with a patient who complains of irritability and fatigue, not realizing that the person’s brain tumor is progressing. Unfortunately, this is not my fantasy, but a real life incident - precious time was lost and human life was endangered. In a word, in order to competently apply psychotherapeutic techniques, a person must have both basic and special medical education.
Currently, more than a hundred psychotherapeutic techniques are known. The most popular today: neuro-linguistic programming, classical hypnosis, Ericksonian hypnosis, Gestalt therapy, body-oriented therapy.. If you are offered such services, ask the specialist to present state-issued documents: a medical diploma and a certificate of psychotherapist.
In what cases does an elderly person need a psychiatrist?
A psychiatrist deals with the most serious, and even incurable, mental problems. As a rule, this is drug treatment with hospital stay under the constant supervision of specialists. Psychiatrists treat or alleviate the condition of patients suffering from various types of somatic disorders, such as dementia and Alzheimer's disease, addictions (alcohol, addictive drugs), schizophrenia, hallucinations, and psychosis.
In addition to medications, the complex of treatment in a hospital may include various procedures and activities that have a positive effect not only on the functioning of the nervous system, but also on the general well-being of the patient. These include: massage, exercise therapy, qigong, electrosleep, hemosorption and plasmapheresis (blood purification), xenon therapy (treatment with inert gas - xenon), hypnosis, etc.
Neuropsychiatrist
A psychoneurologist is not a profession, but a position. In the 60s, the Ministry of Health decided to bring psychiatric care closer to the population. People were afraid to go to psychoneurological dispensaries; going to see a psychiatrist was considered shameful - so the idea arose to create the position of a psychoneurologist in a clinic: the patient does not have to travel far, and the sign above the office is not so scary.
A psychoneurologist could be either a psychiatrist or a neurologist who has undergone additional specialization. Psychoneurologists have been of great benefit. They noticed mental illnesses in the early stages and promptly sent patients to the dispensary, where they received help. It was a very positive experience.
Unfortunately, this position was canceled more than six months ago. As a result, it is now difficult to find a psychiatrist in the clinic. And even if he is, people are afraid to go to see him, despite the fact that the registration of such patients has been canceled and there can no longer be any repression.
When you don't need to register
If you're in a bad mood because of the nasty weather, if you got a bad grade, got fired, or had a fight with your loved one, you don't need a therapist. This can all be solved by a few days of rest, that same conversation with loved ones and a cup of hot chocolate or watching a football match.
If you have experienced severe stress, grief, cannot resolve a conflict that has been dragging on for a long time, and you really need to understand your feelings in order to understand what to do next, then you should see a psychologist.
However, if you are afraid that all these situations will have a bad impact on your life and decide to see a psychotherapist, it won’t get any worse. The doctor will help himself or refer you to the same psychologist (or to a psychiatrist if it turns out that your illness is more serious than expected).
Psychologist
To become a psychologist, you need to study for 5 years at a university at the Faculty of Psychology. Please note: psychology and pedagogy are two completely different things. The teacher does not have the knowledge and skills necessary for this complex work. Nowadays, in some private universities, pedagogical and psychological faculties have been created, which issue a diploma of “psychologist-teacher”. In my opinion, this is unacceptable.
I also want to note that a psychologist does not have the right to treat mental illness. This is the prerogative of a psychiatrist.
Today, according to the register of specialties, there are four specializations of psychologists.
Pathopsychologist
assists the psychiatrist in diagnosing mental disorders. If a psychiatrist makes a diagnosis based on the clinical manifestations of the disease, then the pathopsychologist uses formal examination methods, that is, various tests and scales. Its task is to identify disorders of memory, thinking, intelligence, emotional and volitional spheres and report this to a psychiatrist.
Neuropsychologist
is a diagnostic assistant for a neurosurgeon and neurologist. Its task is to use special tests to indicate exactly in which area of the brain there is damage and what type of damage it is. In neuropsychological tests, disorders of the motor, ideational (sequence of thinking) spheres, spheres of perception and reproduction of information are examined. The specialist knows which part of the brain is responsible for which function. Accordingly, if the patient is unable to complete a series of tests, the neuropsychologist notes in which area of the brain is affected. This information is necessary for the neurosurgeon to perform the operation.
A neuropsychologist may also work in a team with a neurologist and psychiatrist. By repeatedly repeating tests that are difficult for a child, a neuropsychologist can achieve stimulation of the affected areas of the brain. This will become part of the correction program that this trio of specialists is developing.
Social psychologist
based on statistical data, studies society's attitude towards certain social phenomena and makes general recommendations. Roughly speaking, he finds out whether Russian women like the fact that the president wore a red tie yesterday. Based on the survey results, the social psychologist makes a conclusion like: “Mr. President, don’t wear a red tie anymore, because a significant part of your electorate doesn’t like it.” A social psychologist has nothing to do with any specific individual or medicine.
of clinical psychologist appeared
. This model is taken from Western experience. There are psychologists working in services to help seriously ill patients: cancer, HIV-infected, etc. A clinical psychologist must understand what a person is sick with, monitor changes in his mental functions and involve a psychiatrist and a neurologist so that they correct the condition of the seriously ill person and provide him with an acceptable level of existence.
Unfortunately, in our country this idea was misunderstood. As a result, some individuals are trying to prove that a clinical psychologist is able to replace both a doctor and a psychologist. I am afraid that in practice these departments will produce specialists with an incorrect understanding of their own competencies, responsibilities and capabilities.
I would especially like to say about such phenomena as “practical psychologist” and “consulting psychologist”. All these names are advertising signs. There are no such specialties in the register. A practical psychologist is someone who is engaged in practical activities, but this is not a profession. Typically, diplomas with this specialty name are issued at private universities or at paid departments of regular institutes. This is a purely commercial education of rather low quality.
Psychological consultations are, in my opinion, a tribute to Western fashion. As a rule, consultants listen to clients, let them cry, and sometimes give a couple of banal recommendations. The consultant has no right to treat neuroses and other mental illnesses. It’s good if he identifies problems and refers the person to the right specialist. It is much worse if, in pursuit of profit, he keeps with him a client who needs a doctor, and not a confession.
Of course, a psychologist is needed in schools. This position should be held by a professional pathopsychologist or clinical psychologist. The duties of such a specialist should include the following:
- diagnose higher nervous activity in children (intelligence, thinking, memory, etc.). Based on the results of the study, the psychologist should help the teacher teach a specific child or class, and if necessary, should refer the student to a doctor;
- evaluate relationships in the team and form them;
- participate in the creation and implementation of correctional techniques;
- inform parents and teachers about conflict situations and lead working groups on conflict resolution;
- establish contact between teachers and parents, teach them technologies for communicating with each other and with children;
- conduct intensive training-type classes.
Unfortunately, the position of school psychologist is often filled by people who would otherwise be laid off. As a rule, these people do not have a psychological education, and the short retraining that some of them will undergo in courses is not enough for professional work.
When is it time to make an appointment?
Mental disorders rarely appear out of the blue; as a rule, the symptoms gradually become stronger. The following should be on your guard:
- The character has changed. The person becomes withdrawn, loses interest in business, and does not communicate with people who were previously important.
- Confidence in one’s own strength disappears, so much so that one doesn’t even want to start something, because one is sure of failure.
- I constantly feel tired, I either want to sleep or do nothing.
- The reluctance to move is so strong that even simple actions (take a shower, throw out the trash) turn into a task for the day.
- Incomprehensible sensations appear in the body. Not pain, but just something completely indescribable or very strange.
- The mood quickly changes for no apparent reason from intense joy to complete despondency.
- Unexpected emotional reactions appear: tears when watching a comedy, despondency in response to “Hello, how are you?”
- Aggression and irritability are often present.
- Sleep is disturbed: insomnia or constant drowsiness occurs.
- Panic attacks are coming.
- Eating behavior changes: systematic overeating or refusal to eat is noticeable.
- It's hard to concentrate, study, and get things done.
- Obsessive repetitive actions and habits have appeared or become more frequent.
- You want to harm yourself (or it is noticeable that a person is hurting himself: there are minor burns, scratches, cuts on the body).
- Thoughts about suicide appear.
These are not all approximate symptoms that signal difficulties in the functioning of the psyche.
The main criterion: if something interferes with your life and reminds you of itself every day, go to the doctor.
If you notice any symptoms in a loved one or friend, offer to help. Do not scold a person or laugh at him, do not force him to undergo treatment. Say what's bothering you and ask what you can do to help. Find helplines or addresses of specialists so that a person can contact them.
Psychoanalyst
Today psychoanalysis is a commercial sign. Its essence has little in common with what Freud and Jung did in their time. Anyone can come to the Institute of Psychoanalysis, pay money and receive a diploma as a psychoanalyst. Apart from the modern concept of psychoanalysis, these specialists know nothing - neither medicine, nor psychology. At the same time, they claim the universality of their approach.
This entire organization is built like a pyramid, like Herbalife. First you have to undergo psychoanalysis yourself - it's expensive. In two years you will become an assistant psychoanalyst. You will be paid some money, but you will spend it on additional psychoanalysis sessions. And only then can you practice on your own. In one word: “Eat Herbalife, trade Herbalife!”
Freud would turn over in his grave seeing this.
He was a brilliant psychiatrist and invented psychoanalysis as one of the psychotherapeutic techniques with his own concept of the origin of mental pathologies. It is in this “pure” form that psychoanalysis has taken root in psychotherapy and is used by some psychiatrists to this day. Article from the May issue of the magazine.
Who should I go to for treatment?
The modern rhythm of life is accompanied by regular stress, nervous tension, and our psyche is subjected to powerful stress. Someone is able to cope with this by relaxing in time, giving the body rest. But sometimes your internal resources run out, and you realize that something incomprehensible is happening to you, something that you are not able to cope with on your own. And this means that it is time to seek help from a specialist.
To whom exactly? Let's try to figure it out. A psychologist, psychotherapist and psychiatrist have one goal - to help the patient restore his damaged psyche. But they do it in different ways.
Psychiatric care
If a psychologist examines mental problems, then a psychiatrist is a doctor who deals with complex and serious pathological changes in the patient’s body systems. The work of this specialist is strictly regulated by law, which even provides for the possibility of providing assistance on an involuntary basis (in particular, hospitalization and treatment in a psychiatric hospital on an involuntary basis). Patients turn to a psychiatrist in severe crisis situations, when serious intervention, treatment, or hospitalization are required. However, the psychiatrist also uses conversation and psychotherapy among his treatment methods, so this specialist is definitely “more generalist.” If you have eating disorders, epilepsy, “voices,” disorders of consciousness, perception, behavior, thinking, memory, you should definitely consult a psychiatrist.
