Great Psychiatrists versus Bad Psychiatrists

Years ago, I used to counsel mental health clients. The clients I worked with had hardcore mental health issues, in that they needed both psychiatric and psychological treatment.

It was the psychiatrist's job to mentally stabilize the client enough, so that counseling can be productive. It's virtually impossible to productively counsel a client who is hallucinating all over the place.

How does one convince a psychotic client that unicorns, Santa Claus, and the Easter Bunny don't exist, if the client "sees," "hears," "smells," and "feels" them on a daily basis?

You can be the best psychologist in the world, but if a client is hallucinating all over the place, your counseling isn't going to amount to anything at all. It'll be a complete waste of your time and the client's time.

I've worked with great psychiatrists and very bad ones. The very bad psychiatrists had the tendency of not being open to advice and not furthering their education in modern psychiatry. It's almost as if they think that what they learned many years ago in school is all they need to know forevermore.

They forget that psychiatry is experimental, is driven by research, and is always evolving and changing.

For example, research studies have shown that combination therapy is much more effective in treating refractory schizophrenia than monotherapy. In other words, two low-dose antipsychotic drugs used together are better than one high-dose antipsychotic drug used alone in treating refractory schizophrenia.

The great psychiatrists know this. But the bad ones continue using one high-dose antipsychotic drug in treating refractory schizophrenia. And when they get no positive results at all, they tell themselves, "Oh well, that's the way it is."

Don't be a bad psychiatrist. Instead, keep current in your field, be open to new ideas, and most important of all, believe that you can get positive results and then do what it takes to get them.

Your clients are depending on you.