At least I finished reading this article without banging the screen.

Even though the amount of psychotherapy I have time to practice is abbreviated and minimal at best, I am glad I know what I do.

The young Doctor of Osteopathy who wrote this article has a photo of himself in a circle you can click on to get his coordinates in Doximity.

It is certainly is true today that most psychiatrists are limited to writing prescriptions for their charges.

It does not mean that it is necessary or in any way helpful or good or going to advance.

It is true that psychotropic medications have a lot of side effects that suggest a patient may require management for hypertension or type II diabetes or the like.  Teaching management of “basic” metabolic problems makes no sense to me.

Diabetes, type 2, is poorly managed in most everyone I see.  Sometimes patients know the difference, sometimes they don’t notice, and an amazing amount of the time they simply don’t care.

Few things are more frightening to me than generalizing a specialist to “help” primary doctors treat things they don’t think are important enough to deal with properly.

There is much online about how to control, reverse, or prevent “simple metabolic problems” for those who refuse to follow the dictates of a broken medical system.

We are talking about another kind of transferring responsibility, abduction from the responsibility of doing psychotherapy, becoming part of psychiatric therapy.

By the nature and importance of psychotherapy in psychiatric healing, it is simply too large a responsibility to get rid of entirely in training.

Many patients are identifying their medication as but a single force that promotes healing.

See the work of Dr. Fisher and Empowerment Center, which I have already written on.

Talk to the patients.

Then, talk to the therapists.

They have varying degrees now.  Not just PhD.’s but PsyD’s, nurses, masters’ level, marriage and family, associate degrees, and alphabet soups I just call and ask about if they seem too unfamiliar.

I was told way back when I was in training that psychotherapy by a psychiatrist was just too expensive for any insurance company to actually want to pay for.

The idea, purely economically driven, has become to send people to two professionals, one psychotherapist, and one pharmacologist, to get the job done.

I have, over the years, lowered my expectations for whatever it is that I consider a therapist.

I was generally not in too bad a situation when I worked in an academic setting.  I expect they have changed.

I am now looking for therapists who are capable of articulating what kind of therapy they are trying to do, and how they do it, and what their goals are.

Sometimes patients are referred by therapists whom they have already been seeing for weeks, for months or even years.

Some of these folks have literally told me they see the patient once a week, ask the patient what happened that week and, I quote, “tell the patient what she is feeling.”

Honest.

I informed a PsyD. not long ago that her patient “had not yet done her Oedipal” and needed to get this done or she was unlikely to resolve her anxiety.

This person seemed to have no idea that an Oedipal Complex” was described by Freud as the “resolution” of a childhood state in which one is attracted to the parent of the opposite sex and in competition (real or imagined) with the same sex parent.  Named after Oedipus Rex, Monarch of Greek tragedy who killed father and married mother.

I offered free help and supervision to this allegedly credentialled therapist who never heard of such a problem.  This girl had the hots for dad.

I have no use for this sort of therapist who had allegedly never seen such a case and denied free teaching from a person like me who had seen, “a couple dozen, at least.”  She is par for the course.  “Easy hours” and “all my weekly slots filled” are the phrases I hear the most from them.

I rarely refer to therapists, unless they are personally known to me to do decent, honest work.

All of this makes me think of yet another concern.

I remember it was approximately when I was in residency training, that some “doctors of osteopathy” actually took additional training to become the alleged equivalent of an M.D. before applying to medical residency programs.

Now this does not seem to happen.

I do know the number of people practicing who are osteopaths seems to be increasing.  They seem to be a bit more frequently in primary care (internal medicine, OBGyn, and family practice).

Years ago the chief of my residency program checked out some doctors of osteopathy and found their training was too “consumer-oriented” for the way he thought a psychiatrist was supposed to think.

Me, I give him proper respect for believing that psychiatrists get to think.  It usually gets me in trouble.  Especially thinking about anything too much.