Monday, May 11, 2009

Psychiatry without Psychotherapy

An article in the August 2008 issue of the Archives of General Psychiatry noted not only a significant decrease in the number of psychiatrists practicing psychotherapy, but a lack of interest in learning psychotherapy among psychiatric residents in the United States. A letter in the April 2009 issue of the same journal notes that a survey among Canadian residents showed that 84% "anticipated practicing psychotherapy and viewed it as an important component to their work and identities." For those who are inclined to see the rise of biological psychiatry as portending the inevitable decline of psychotherapy, this survey strongly suggests that economic and cultural factors are at work as well. 


  1. Ed,
    I also read the reports of this article, though didn't read the article myself (not yet). I wonder what are the cultural and economic forces, and how blunt are they in the article? E.g. is it stated simply that psychiatrists make less money practicing psychotherapy than they do prescribing? I wonder what the cultural forces might be - less introspection and the supremacy of the medical model of mental illness and distress? - Tony

  2. In the 1990s patients in psychotherapy began accusing parents and other relatives of sexually abusing them in childhood. Most of the accusations were false “recovered memories” implanted by therapists pursuing a new theory of mental illness. Paul R. McHugh saw it all and feared that his profession had done itself in, once and for all.
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    The public, in losing confidence in psychotherapy and turning solely to medications for psychiatric treatment, abandoned an important healing method just as several psychiatrists, including McHugh, were teaching what had gone wrong in psychotherapy and putting it right. Everyone—the public and professionals—should appreciate how psychiatry lost its way on this occasion so as to guarantee that discredited ways of searching memory for sources of disorder do not reappear in some new garb.