TitleMeaning-making in a medical world
NameSmith, Dena T. (author), Carr, Deborah (chair), Horwitz, Allan V (internal member), Carr, Patrick (internal member), Daipha, Phaedra (internal member), Chancer, Lynn (outside member), Rutgers University, Graduate School - New Brunswick,
Psychiatry—Differential therapeutics ,
DescriptionIn this study, I interview psychiatrists and psychologists (N=40) in order to assess their feelings about the role of medication, talk-therapy, and diagnosis in practice; in general, I explore what practitioners feel is the best modality for treating patients. Though there is extensive research on psychiatric paradigms, on prescribing patterns and trends in the use of talk therapy, there is to date no comprehensive project that involves interviews with mental health practitioners - doctors who have become central figures in American culture. I address the assumption in the literature that the classic Freudian, psychodynamic, or psychoanalytic model is at odds with the biological, diagnostic or medical model that dominates psychiatry today. In the 1980s, psychiatry underwent a dramatic shift its approach to treatment; the once dominant psychodynamic model gave way to the biological model, which is characterized by treatment with medications, short visits with doctors, and which targets assumed underlying imbalances of chemicals in the brain. Until the 80s, patients generally engaged in long-term, in-depth talk-therapy with practitioners who believed their problems stemmed from trauma, psychological development and repression. Therefore, psychodynamic therapists believed that uncovering the meaning of patients’ symptoms using the “talking cure” could relieve suffering. Today, there is little psychodynamic practice in the United States. Psychodynamically oriented practitioners are often accused of employing unscientific treatment methods. Most theorists suggest that the psychoanalytic and the biological model are irreconcilable in their assumptions about etiology and treatment approaches. Yet there are a handful of practitioners who choose to train in psychoanalysis to strengthen their talk therapy skills after medical training in psychiatry or graduate programs in psychology. Thus, practitioners negotiate the boundaries between the dynamic and biological paradigms. Given the major changes in the mental health field and the potential struggles for practitioners who work within multiple treatment modalities, I explore how the tensions between the psychodynamic and biological models affect psychiatrists and psychologists. In short, I explore whether and to what extent these potential clashes between these paradigms manifest in practice (and how practitioners avoid them in other cases).
NoteIncludes bibliographical references
Noteby Dena T. Smith
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.