Communicative English, A.K.

Rath, Practice Set 6

Continuation Text
(Psychiatry)

It soon became clear that there was more to psychoanalysis than Freud’s original remote and
neutral exploration of the unconscious. [ 1 ] Analysts began to explore these relationships and
experimented with more active approaches and with different types of therapy (time-limited
therapies, more structured therapies, therapies in groups and in families, etc.). [ ] These
psychological approaches, in which the relationship was used actively through talking to
promote self-awareness and change, are broadly understood as ‘psychotherapy’. [ ] The
relationships formed in this intense treatment were themselves found to be influential. [ ] These
(e.g. non-directive counselling, existential psychotherapy, transactional analysis, cognitive
analytical and cognitive behaviour therapy) draw on a range of theoretical backgrounds. [ ]
Most of the early psychotherapies leant heavily on Freud’s theories (often called
‘psychodynamic psychotherapy’ to emphasize the impact of thoughts and feelings over time) but
several of the newer ones do not. [ ]

What they all have in common is that they use communication within a formalized and secure
relationship to explore difficulties and find ways of either adapting to them or overcoming them.
[ 1 ] Psychoanalysis remains very tightly controlled, by defining strictly who becomes a
psychoanalyst, but psychotherapy is a loose concept. [ ] Most psychotherapists are not
psychiatrists although most psychiatrists have some psychotherapy training and skills. [ ] Some
psychiatrists even work mainly as psychotherapists. [ ] Most psychodynamic psychotherapies
also require (like psychoanalysis) that the therapist undergoes a treatment themselves as part of
the training. [ ] Some schools of psychotherapy are strict about whom they admit but the title
‘psychotherapist’ could, until recently, be used by anyone. [ ]

First and foremost, psychiatry is a branch of medicine – you can’t become a psychiatrist without
first qualifying as a doctor. [ ] There are overlaps with the other ‘psychs’ but there are some
fundamental differences. [ ] So if it is not psychology and not psychoanalysis or psychotherapy,
what is psychiatry? [ ] Having qualified, the future psychiatrist spends several years in further
training. [ ] He or she works with, and learns about, mental illnesses in exactly the same way
that a dermatologist would train by treating patients with skin disorders or an obstetrician by
delivering babies. [ ] Within medicine, psychiatry is simply defined as that branch which deals
with ‘mental illnesses’ (nowadays often called ‘psychiatric disorders’). [ 6 ]

Medicine is fundamentally a pragmatic endeavour. [ 1 ] We don’t have to know how the

treatment works. [ ] While drawing heavily on the basic biological sciences and scientific
methods, the ultimate test of whether a treatment is right is if the patient gets better. [ ]
Whatever is viewed as mental illnesses (and this has changed over time), and whatever
treatments are available for these illnesses, will determine what a psychiatrist is, and what he or
she does. [ ] Therefore the definition of psychiatry is not based on theory, as in psychology or
psychoanalysis, but on practice. [ ]