The Story Of A Psychiatrist In Private Practice

You may wonder what happens when someone--a friend, neighbor, coworker or relative--needs to go see a medical doctor specializing in psychiatry.  Don't feel bad if you don't know.  Many people have no idea, and that makes it such an intimidating step to take.  I will open the doors of my office and demystify the process for you so that if you or a loved one needs to see a psychiatrist, you will no longer hesitate to call for that first visit appointment.

Usually, by the time people come to see me, they have already delayed a long time asking for help.  Not knowing for sure even what that means makes them hesitate.  After they realize they have an emotional problem that will not go away by itself, they try first to handle it by themselves.  They read self help books, take vitamins or other supplements, change their diet and take other reasonable actions that normally should work.  But when these reasonable actions don't work, people start looking for some kind of help.  Discretely at first, they try talking to trusted friends about how they feel, then consider seeing a psychotherapist.   Psychotherapists could be marital and family therapists (MFTs) or licensed social workers or religious counsellors or licensed psychologists (PhDs or PsyDs).  Because these specialists are known for practicing "talk therapy," going to see them seems less intimidating.  But even if that reasonable measure doesn't work, they will finally consider going to see a doctor like myself, a psychiatrist.

This is my office.  Welcome to my practice! 

Seeing a psychiatrist is in general not that much different than seeing a psychotherapist.  The main difference is that the psychiatrist is a trained physician so she will look at the emotional problem from a medical perspective.  That includes a series of technical questions, like understanding what exactly are the symptoms that need to be treated, their duration and intensity.  These questions are meant to help match the symptoms with specific medications designed to treat them.

The way psychiatrists work vary.  There are psychiatrists that address strictly the target symptoms and prescribe medications.  But if you see a psychiatrist like myself, that will be only a part of what is being addressed.  Because I incorporate various forms of psychotherapy in addition to prescribing medications, I will also be interested in understanding the toll that these symptoms have taken on my patient, how they impacted his relationships, his social and professional life, what dreams and ideals have been blocked by these symptoms.  I am also interested in figuring out what my patient has done to address the promblem and what work and didn't.   I am looking for enough information to be able to design a comprehensive, wholistic plan to address my patient's problem.  This plan may or may not include the use of medications.  Usually medications can be helpful addressing symptoms like insomnia, anxiety, depression, anger, impulsivity, but they will never be able to help people making healthier decisions for themselves and definitely they are unable to change one's life.  But changing one's life is, in the end, the best long term treatment and the one that leads to the best outcome.

People suffer emotional pain when something internally or externally is going very wrong.  This may or may not be immediately obvious and it may or may not be easy to fix.  But fixing it needs if one wants to move forward in life and gain success and peace of mind and heart.   You will not hear this from all my fellow psychiatrists.  It is a failure of my field that many of my colleagues focus too narowly on the medical (biological) aspect of emotional imbalance and too little on the emotional one.

But it is my experience that unless I look at my patient as a whole, and together, doctor and patient, try to affect change at multiple levels--biological, social, interpersonal, to name only a few--of the problem, that problem will never get better in a substantial way.  Partial improvements are no longer good enough.  In my practice, the goal for my patients is not just to feel a little better, or relatively well, or somewhat better than what they thought is good enough.  My goal is for them to be cured, solve the emotional problem at its roots.  I want them to become even better than cured, achieving more insight than they had before, more emotional strength and mastering more ways of coping with life's adversities than they ever had before.  Better than cured, as one of my patients once said.