What does a psychiatrist do?
How is a psychotherapist different from a psychiatrist?
Who is a psychoanalyst
What do psychologists and psychotherapists have in common?
Psychologist and psychotherapist, what is the difference?
Clients often ask me, how is a psychologist different from a psychotherapist? This is a very important question, the answer to which led me to the transition from psychological counseling to psychotherapy. Working within the framework of psychological consultations, I was constantly faced with my own limitations when interacting with people with impaired mental organization. It became important for me to expand the scope of my competence, to gain more knowledge about the emotional world, the work of the mind and the structure of the psyche in general.
What is psychoanalysis?
Psychoanalysis is a unique technique of self-knowledge, the founder of which is Sigmund Freud. Revolutionary theory consists of a radically different view of the inner life of man.
Psychoanalysis is a profound practice that helps change human destiny. Giving you the opportunity to understand your true Desires.
And by understanding our desires and our own unique history, we are given the opportunity to “consciously” live life and are given a choice where there was none before.
Who is a psychoanalyst?
A psychoanalyst is a person who has a specialized psychological or medical education and has undergone additional retraining in this area. There are main ways to become a psychoanalyst: 1) Appropriate education and a certain amount of supervision; 2) Reading books on psychoanalysis (Freud and his followers); 3) Own analysis, and it is at least 250 hours. This is necessary in order not to shift your own problems onto the person.
Therefore, when choosing a specialist, ask where and how many hours he himself lay on the couch.
There is an interesting video where Professor M. Reshetnikov discusses the topic of modern psychoanalysis and what the work of a psychoanalyst consists of.
So what is the main difference between psychoanalysis and other psychological techniques?
Psychoanalysis works to change the structure and character of the psyche, to find out the root cause and work through it, and not to relieve the symptom.
Psychoanalysis was the first to discover the method of “healing” by talking and, probably, that’s why he succeeded in it better than anyone else. The special technique of free association provides tremendous success in becoming aware of the unconscious. The technique is distinguished by a special way of thinking, in which a person says everything that appears in his thoughts. Trying not to criticize and discard unnecessary things. The trick is that there is nothing unnecessary. At the same time, the psychoanalyst, knowing how to listen in a certain way, analyzes everything that is happening now in the office and tries to understand where the unconscious has manifested itself at the moment.
Essentially, a psychoanalyst is a person who analyzes your echoes of the unconscious and presents them in a “digestible” form.
A small remark, the unconscious is all that part of our psyche that has a colossal influence on our lives and, for some reason, is not in the field of consciousness. The causes of our neurosis, phobias, true desires and much more can be hidden in the unconscious.
In the process of analysis, a person acquires memories of his own unique history, the ability to understand his desires and an awareness of cause and effect. At the same time, a colossally important right of choice is acquired where it did not exist before. Therefore, the analysis cannot be fast. After all, you need to have respect for your neurosis, which has been developing throughout your life. And you want to get rid of it in a couple of sessions. There is one unshakable rule in psychoanalysis: each subject is unique. This is reflected in the fact that the analyst never takes the position of “truly knowing.” And he will never give you advice or some techniques that you will need to use. Because, behind the seemingly “understandable” symptom and the sweet position of the “knowledgeable teacher,” there is a huge mistake in not seeing the unique structure of the analysand’s psyche and fate.
Psychoanalysis is like an island of freedom.
In the modern world, where a superficial view of man prevails. Where great attention is paid to external indicators and success. And a person devotes all his free time to “upgrading” himself and creating an image. Psychoanalysis remains an island of freedom, where the inner world is important, without trying to adapt it to current reality. The opportunity to meet yourself, without any evaluation from the analyst, gives you a chance to get to know your own true desire, to freely express your thoughts and emotions.
Why do people turn to a psychoanalyst?
Each person is a unique story and therefore appeals may be different. This could be a feeling of apathy, the meaninglessness of life, a feeling of emptiness, obsessive states, phobias that repeat life situations, a crisis in relationships, experiences of grief, loss of meaning in life, as well as any other topics that you would like to discuss. The psychoanalyst represents the image of a guide who does not judge or give advice, who walks alongside you and illuminates your path with a flashlight, as he has a map of the area. A listener who will not leave any of your thoughts unattended.
Client-centered psychotherapy
Did you know that the second most popular therapy in the world (after the psychotherapist), at the moment, is considered Client-centered therapy, the founder of which was the American psychotherapist Carl Rogers at the beginning of the 20th century.
His theory sparked a revolution in psychotherapy. According to it, not the specialist, but the client himself is the same psychotherapist for himself. A person who needs help, with the help of his hidden resources, is able to get out of a difficult life situation on his own.
Then why do you need a psychotherapist? He should only guide the patient and reveal his potential. The psychotherapist creates a positive atmosphere, and agrees with him in everything, accepts his words and actions unconditionally.
The treatment procedure itself involves a dialogue between two absolutely equal individuals. The patient talks about what worries him, answers his own questions, and tries to find ways and means to get out of his condition. The doctor supports him in everything and empathizes with him.
The patient gradually, feeling supported, begins to open up, his self-esteem rises, he begins to think rationally and, ultimately, finds the path to becoming a full-fledged person.
In my opinion, this is a very humane method.
Who is a psychologist?
A psychologist is a specialist with a humanitarian education. This is like a connecting word for the general definition of people in this profession. Psychologists are:
• people working in the field of theoretical scientific issues. Practitioners involved in testing and various studies. • psychologists in schools, kindergartens, clinics and other government institutions. The job is low-paid, so don’t expect to meet a smiling person there who is ready to listen and sympathize with you for hours on end. • specialists in private practice (in the common people, they can “illegally” call themselves psychotherapists). We’ll talk about them in more detail below, since the directions there are a carriage and a small cart. • Clinical psychologists working in a psychoneurological clinic and focused on deep mental disorders.
In what cases do you contact a psychologist:
• Depression, feeling of apathy; • Loss of a loved one, separation, death; • Feeling of loneliness, incomprehensibility; • Sharp outbursts of rage or excessive shyness, passivity; • Lack of understanding of your feelings, confusion in thoughts; • Professional burnout; • Personality crises: teenage, middle age, etc.; • Panic attacks, phobias, fears; • Loss of interest in life; • Experiencing a traumatic situation; • Problems in relationships with people. • Sexual problems; • See the motivation and implementation of internal resources. The list is not complete, since each person is individual and the job request also cannot be classified.
What directions exist in psychology?
Oooh, this is where all the variety of methods and directions that exist at the moment is.
Let's go over the tops of these icebergs and briefly describe them:
1. Psychoanalysis. The brilliant creation of S. Freud, which provided the foundation for many modern trends. And what caused great damage to a person’s pride for the third time was the discovery of the unconscious and the description of the structure of the psyche. Copernicus was the first to point out that the Sun does not revolve around the Earth, but rather the Earth revolves around the Sun. The second is Darwin, with his theory of the origin of man from the ape. And the third is Freud, who showed that what a person is aware of about himself is not him. The theory is focused on deep psychology, working through internal conflicts, and deep understanding of oneself and one’s true desires. Since the process tends to go deeper, it takes longer. Therefore, therapy is long-term. Well, it was described in more detail earlier.
2. Transactional analysis. The founder of the theory, E. Berne, a follower of psychoanalysis, created his own theory of personality. Therapy is based on the interaction of three ego components of a person: the inner parent, the adult and the child. This interaction occurs both in the outside world, when communicating with other people, and as an internal dialogue with oneself. Internal dialogue often takes the form of conflict, filled with difficult feelings. A striking example of this: “I want” and “I need.” In the process of therapy, these parts are analyzed, getting rid of negative influences, exploring childhood experiences and how the outcome appears “Choice”.
3. Gestalt therapy. Gestalt is something holistic, complete. And therefore therapy is based on completing the processes that interfere with life (unfulfilled needs, unpleasant situation, resentment, anger, etc.). Closing the gestalt provides liberation from it. Why is it so important to close the gestalt? - because this is a time bomb, it is not clear when and where it will explode. Also, one of the areas of therapy is that this skill is in the moment, as it is now fashionable to say “here and now.” In therapy, great attention is paid to feelings as a guide to one’s own needs, the environment and the satisfaction of these needs in interaction with the world.
4. Symboldrama. Or the “daydreaming” method is free fantasy on any topic or one previously presented by a psychologist. The process goes as follows: a person relaxes, imagines an image, retells it to the therapist and analyzes it with him. The method gives a softer touch to traumatic situations and unconscious fantasies. Symboldrama is suitable for people with a developed emotional and figurative structure of experience, an irrational way of solving mental problems.
5. Cognitive behavioral therapy. In my opinion, it works great for relieving symptoms and developing new thinking skills. It is intended for short-term therapy, usually 10-15 sessions. On which you will be able to realize the main errors in thinking and reaction behavior. During therapy, it becomes clear what negative attitudes and thoughts influence behavior. The situation lends itself to critical thinking and negative attitudes are replaced by positive ones. That is, the main task of a specialist is to get to the essence and teach a person techniques of positive thinking.
6. NLP or neurolinguistic programming. It has in its arsenal special techniques for modeling verbal and non-verbal behavior and developing special connections between eye movements, memory and speech. If you retell all this in ordinary human language, it turns out that you are trying on the mask of a successful person and trying to adjust these skills in yourself in order to achieve success in the same area.
7. Art therapy. A direction in which psychology and art and creativity merged. What is difficult to express in words is expressed well in creativity. That is, when immersed in any process, be it drawing or dancing or music, our “cunning mind” forgets about caution and shows our emotional state and inner experiences as they are. And at the same time, an excellent opportunity arises to process, that is, to “pour out” some of the internal emotions that we have so diligently restrained (for example: sadness, pain, fear, euphoria, etc.). It is an excellent diagnostic tool if you have an experienced specialist with you who can decipher your creative product.
Gestalt approach in psychotherapy
We all want something and strive for something. Figuratively speaking, by satisfying our immediate needs, we, as it were, close the gestalts.
When we want something, but we are unable to fulfill this need, we begin to get nervous, internal tension arises, these are “unfinished gestalts.”
Each need goes through several stages of development:
- Its necessity is formed and realized.
- The body begins to contact the outside world to find what it needs. The need is satisfied.
- Analysis and comprehension of the experience we received.
But if the need is not satisfied, the problem grows and can lead to unpredictable results. For example, let's talk about jealousy in a married couple. The wife is constantly jealous of her chosen one, starting noisy quarrels, accusing him of constantly being late at work. In other words, she projects her suspicions onto her husband, while the wife's need for love and tenderness is not satisfied.
And here the help of a Gestalt therapist is invaluable. He helps the patient recognize the need while suggesting appropriate methods. Instead of eternal accusations, you can find other words that will not lead to a scandal, for example, “Darling, I’m very worried that you’re coming home so late. I really miss".
It seems that everything is simple. But, unfortunately, not all people can act correctly in a conflict situation.
A Gestalt therapist helps with finding ways to get out of the “mode of isolation and autonomy”, using contact with the environment, with people, and not “locking” the development of the need from the inside.
Who is a psychiatrist?
Let's start with a psychiatrist, about whom all sorts of horror stories have been circulating from generation to generation since Soviet times. A psychiatrist is a doctor who has received medical education. He works, in most cases, with psychopathologies, i.e. with mental disorders.
When should you contact a psychiatrist?
- In the presence of delusional thoughts, which manifest themselves in confidence in something that actually does not exist;
- The presence of voices, visions and other manifestations of hallucinations;
- Violations of criticism regarding one’s own behavior;
- With deep depression;
- Panic fear;
- Behavior that is inexplicable to others;
- Problems with attention, thinking and memory;
- For drug or alcohol addiction.
Etc., the list can go on and on, but I think, in general terms, several points can already give an understanding of why they visit a psychiatrist.
How is the treatment carried out?
This usually happens like this: the doctor recognizes your symptoms, examines the cognitive part and, based on his invaluable experience, makes a diagnosis and prescribes medication. Accordingly, he bears full legal responsibility for this.
He does not listen to your stories about the injustice of your childhood about an overprotective mother and an overly demanding father. Not because he is a callous and boorish person, but because he is first and foremost a Doctor and is focused on drug treatment. In addition, there is a regulation according to which a maximum of 15-20 minutes is allocated for each patient, and there are other specialists for conversations.
Can someone other than a psychiatrist (for example, a psychologist, psychoanalyst, etc.) give a prescription for medications?
No, because only a DOCTOR can write prescriptions. This applies to both strong antipsychotics and conventional antidepressants.
Do they register with the PND (psychoneurological dispensary) when visiting a psychiatrist?
There is an opinion that when contacting a psychiatrist, a person will be immediately registered. Let's understand today's realities of life.
Observation and treatment by a psychiatrist are divided into: 1. Medical and advisory assistance. 2. Clinical observation.
From the first it follows that the patient voluntarily comes to see the doctor and also voluntarily takes medications. If he suddenly changes his mind, no one will look for him and find out what’s wrong with him. Dispensary observation is not carried out in this case.
In the second case, if there is a mental disorder that occurs with severe exacerbations and periodicity (for example, paranoid schizophrenia), then a commission of psychiatrists, on the initiative of the attending physician, establishes dispensary observation for the person. This means that the patient is treated at his own request, but according to a certain schedule he needs to visit the attending physician for examination and prescription of medications. To place a person under dispersed observation, his condition is monitored for a long time. It is illegal to establish surveillance after the first visit.
Where can I go for free?
City Clinical Psychiatric Dispensary (Bekhtereva St., 5, gkpd.by)
City Clinical Children's Psychiatric Dispensary (Ya. Luchiny, 6/1n, gkdpnd.by)
Republican Scientific and Practical Center for Mental Health (Dolginovsky Trakt, 152, mentalhealth.by).
Local children's and adult clinics in the city - yours can be found here.
If you need emergency help and don’t have time to look for a specialist, you can contact the 24-hour hotline:
Emergency psychological help for adults: +375 17 290 44 44, +375 17 290 43 70
Emergency psychological help for children and adolescents: +375 17 263 03 03
Emergency psychological assistance for minors in crisis: 8 801 100 16 11.
Some private psychologists and psychotherapists have a percentage of free clients. For example, these are led by psychologist and psychotherapist Ekaterina Kholod , whom you can turn to if the case is very acute.
Psychotherapist and his difference from a psychiatrist
In Russia, only psychiatrists who have completed additional education in the field of psychology can be called a psychotherapist. They are like a connecting link between psychiatrists and psychologists.
Surprisingly, in the countries of Europe and America there are no such strict criteria; their psychotherapists can be both psychiatrists and psychologists. Therefore, our ordinary Russian people are often confused by foreign films with figures of psychotherapists. Who, sitting in a chair, with a languid look, receive the client lying on the couch and conduct conversations with him, due to which the treatment takes place. In Russia, this is usually done by psychologists.
To summarize, a psychotherapist is a psychiatrist who has decided to move to the “dark” side of psychology and start helping people in a non-medicinal way. You can turn to him both in severe psychopathic conditions and to solve pressing disturbing moments in life. But in the realities of our time in Russia, psychotherapists are called all and sundry, including psychologists and psychiatrists))) On a side note, I would like to note that the education of a doctor does not always give an advantage in competence and usefulness for you. In this delicate profession, it is the personality of the specialist who treats and it is better to focus on this when choosing. So psychologists are often much more productive for a person because they do not look at you from the perspective of a patient.
To summarize, we can say that when choosing which specialist to go to for one reason or another, one should not forget that the main figure is not the method in which he works, but the person himself. Therefore, carefully check the education, competence and availability of your own analysis. And don’t forget about the feeling of comfort and safety in the office, because in order to trust you need to trust.
Let's sum it up
Psychotherapy is long-term in-depth work aimed at improving the quality of life, changing the perception of oneself and others, and improving the patient’s social adaptation. From a neurobiological point of view, this is the work of creating new neural connections in the human brain. Psychotherapy takes place within certain limits. In the global tradition, the term “psychotherapy” is used when we are talking about deep person-oriented interventions aimed at changing personality, and the term “psychological counseling” refers to the field of predominantly problem-oriented interventions related to the tasks of adaptation to the current problem situation.
If you have not yet decided whose help you need—a psychologist, a psychotherapist, or perhaps a psychiatrist—you can schedule a consultation with me. Based on your request and after describing your condition, I will help you determine which specialist you need. To register, please use the feedback form or messages in instant messengers. As soon as I am free, I will definitely contact you. Thanks for understanding!
Author of the article: psychoanalytic psychotherapist Natalya Kulikova.
