Psychologists and Psychiatrists Approach Mental Health Differently

Justin Karter
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Psychiatrists and psychologists have traditionally taken distinct approaches toward mental health and, according to a new study, these differences may be here to stay. Researchers in the UK surveyed psychiatrists and psychologists in training about their perspectives on the causes of mental health issues and found that, despite attempts to integrate the field, the two disciplines “continue to sit at opposite ends of a biological/psychological spectrum.”

“We found that trainee clinical psychologists continue to favor psychosocial over biological understandings of mental disorders, giving the cognitive, behavioral and psychodynamic models equal value overall,” the researchers, led by Rebecca Read, write. “These findings may be useful for those involved in developing clinical training programs and multidisciplinary working because they provide an insight into the attitudes of emerging clinical psychologists.”

psychology-vs-psychiatry

The researchers designed their study based on the work of Harland (2009) who developed a tool, the Maudsley Attitude Questionnaire (MAQ), for assessing mental health professionals preferred concepts of mental illness. The questionnaire asks the respondents to endorse, to varying degrees, ideas about mental health based on biological, cognitive, behavioral, psychodynamic, social realist, social constructionist, spiritual or nihilistic approaches.

Harlan’s research used the tool primarily to assess the perspectives of psychiatrists, finding that most strongly endorsed biological explanations and procedures. To compare these results from trainee psychiatrists to the next generation of psychologists, the researchers adapted the MAQ and surveyed 288 psychology graduate students from twenty-four of the twenty-nine clinical psychology training programs in the UK.

They asked the students to score their level of agreement with thirty-two different statements about four different diagnoses: schizophrenia, major depression, generalized anxiety disorder and antisocial personality disorder.

Overall, the psychology students strongly favored social realist statements, such as “social factors such as prejudice, poor housing, and unemployment are the main causes of the disorder.” Meanwhile, psychiatry trainees were most likely to endorse statements based on biological concepts, like “the appropriate study of the disorder involves the discovery of biological markers and the effects of biological interventions.”

While psychology trainees showed less endorsement of biological statements for all four diagnoses than psychiatrists, their preferences for various models did vary depending on the diagnosis in question. For example, the survey revealed that psychologists were more likely to accept biological explanations for schizophrenia than for anxiety or antisocial personality disorder.

When it came to assessing different types of psychological perspectives, psychology trainees showed no significant preference for cognitive, psychodynamic, or behavioral therapeutic models.

“As expected, findings suggested that the immediate social circumstances of the individual as well as wider social context are more important in psychologists’ conceptualizations of mental disorders than biological factors.”

 

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Read, R., Moberly, N.J., Salter, D. and Broome, M.R., 2016. Concepts of Mental Disorders in Trainee Clinical Psychologists. Clinical psychology & psychotherapy. (Abstract)

22 COMMENTS

  1. And this is why psychiatry should be completely abolished and we just stick to psychology. Psychiatrists primarily favour a biological perspective even though there is no evidence to support the notions of biological illnesses, brain diseases, chemical imbalances, or genetic defects, and much evidence to actively disprove such claims. Psychiatrists are flat earthers or believe the moon is made out of cheese. Their entire profession is based around assumptions that have been proven wrong yet they continue to believe them anyway — and force that belief onto others — often with disastrous consequences which they then blame on a mythical disease that never existed.

    Psychiatrists don’t treat the insane. They are the insane.

  2. I think psychology can be damaging (not to mention expensive and time consuming) to many of us…and in the US, its more common to have the talking professionals working with the prescribing shrinks, with result of additional costs and ever increasing layers of pseudoscientific jargon and straight up bullshit.

    I don’t think all that many people in Mental Health, Inc. do much good for their “patients,” “clients,” “consumers,” etc. There are, of course, exceptions to the rule; some “professionals” manage to genuinely help the people in their care. Most of the time…from what I’ve seen and experienced…Mental Health, Inc. covers up social problems and genuine problems in living with whatever flavor psychobabble is en vogue at the moment.

    And of course…both the MDs and the PhDs have a power that is denied all “patients”: the power to label, to define, to construct a life story. A doctor who does a 15 minute med check now and then…and psychologist who babbles on for an hour, as long your insurance is shelling out…they are the recognized “experts” on the “patient,” his life, her experiences, his heart of hearts. By the time the “patient” realizes that its overpriced, damaging, often straight up dangerous bullshit…its too late.

    • “in the US, its more common to have the talking professionals working with the prescribing shrinks, with result of additional costs and ever increasing layers of pseudoscientific jargon and straight up bullshit.” I found this to be true, too. Both the psychologist I dealt with, and a friend who is a psychologist, tended to believe in the DSM disorders and the necessity of the psychiatric drugs, including for a child who was on drugs with major drug interaction warnings.

      English psychologists are much wiser than the American psychologists.

  3. I believe there’s a merit to the both views, just like with any other somatic illness. There is an innate biological predisposition, but environment and lifestyle pull the trigger. But having psychiatric illnesses to this day diagnosed upon almost exclusively subjective criteria is something to think about. Cheers.

    • shljock: Mental states (such as anxiety, depression, etc., which are caused by day-to-day stresses and lived experiences) will bring about changes in neurochemicals. But these changes can be reversed when these day-to-day problems are solved, when circumstances change, etc. (changes happen through neuroplastic and epigenetic mechanisms in the brain). In vary rare occasions (for example, if an infection happens, or when taking certain medications, etc.), the normal equilibrium of neurochemicals can be lost and that can bring about psychological issues. But this is very rare. In various organs of the body (spleen, liver, etc.,), only a very small number of people suddenly develop health problems due to biological abnormalities that just happen to occur in those organs. Therefore, it is unwise to simply assume that psychological issues are caused by biological abnormalities that just happen to materialize in the organ brain all of a sudden for no apparent reason at all. This is why I think psychological approaches are best.

      • Adding to what I wrote, as I see it, because the workings of the brain is very complex (with billions of neurons and trillions of synapses that connect and interact in complex ways), the medicines that various drug companies come up with (in a hit-or-miss fashion) to “treat” mental illnesses are more likely to mess up the brain than to heal it.

    • There can indeed be biological predispositions, but they don’t necessarily exist or arise in the brain, which is why so much of this neurobiological investigation is as futile as the treatments. As a simple example: your thyroid isn’t in your brain, but malfunctioning there can lead to all sorts of “mental” difficulties, from cretinism to catatonia to extreme anxiety, depending on the thyroid’s ability to secrete hormones and the nervous system’s ability to use the hormones it produces.

    • Indeed, the concept of biological predisposition is not supported by credible evidence, and as suc, the continued reference to it qualifies as a fixed idea (what psychiatrists themselves would would refer to as an “obsession”). Now it is understandable why psychiatry has this fixed idea–it serves their interests. But that is hardly something we should be building science on.

  4. Really? They needed a study to show that PHYSICIANS have a biomedical approach to mental illnesses? Geniuses, psychology is as much about personal opinion, political bias, and whims. Which victim group is popular vs which group has fallen out of favor. Which diagnosis is in vogue. Remember the mass epidemic of Multiple Personality Disorder? Overzealous psychotherapists looking to cash in on the popularity of what is otherwise a rare diagnosis. They created victims with their psychosocial “sensitivities”. That’s just one example of how psychologists are not scientists and are making it up as they go along. Give me an MD anytime.

  5. Still, the entire field of ‘psychology’ is based on subjective interpretations of humans from observation, claiming that it is some kind of ‘truth,’ even when the client protests–and, in fact, *especially* when the client protests. That should raise some eyebrows, indicating an imbalance in the social structure, which is exactly what can easily undermine healing and personal growth under those circumstances. To me, that’s a social ill.

    Whereas, in reality, this perspective is always limited to the projections of the clinician who claim they are making an “objective assessment,” which is usually way off the mark, and which many feel is simply created from the prejudices of the clinician. This may pass as some kind of “clinical truth,” but I don’t think it has anything to do with “human truth,” in the most authentic and heart-based sense. Often, the reality of the clinician and the reality of the client are so vastly divergent, it’s hard to imagine how effective and even-handed communication can even occur, which it so often does not, another red flag.

    This field of ‘mental health’ is, in reality, all academic and subjective, based on social norms and whims, to preserve “power.” It is not a grounded reality, which is why it leaves so many people utterly confused. There are much clearer and sound perspectives from which to operate when it comes to actually healing and evolving forward.

    • Plus, they’re both based on attracting people who have been traumatized and victimized, profess to be their advocate so that they will make themselves vulnerable and spill their guts “confidentially,” and then proceed to exploit them, for a fee. It may not start out as exploitation and a clinician may have the authentic intention of helping someone.

      But I think it becomes apparently pretty quickly that the clinician really does not know how to help the client, but they will continue working under the pretense that they know what they are doing, and wind up gaslighting–even unwittingly–the client into believing that they have some kind of personal and social defect which will require their ‘service’ interminably. Sorry, but it is a harmful–and even deadly at times–scam. This is one big lie, a grand social illusion. I believe the evidence of this is all around us, in every direction. The mental health field has done society no good whatsoever, and has, in fact, tanked it considerably. I think it’s obvious. It is way too messy, confused, and fraught with conflict to be an effective healing environment. No clarity or justice, either. Just a big mess, from where I sit.

      Over the decades I have been involved with the mental health world one way or another, I have never, ever seen it SOLVE any problems, only create more of them. It is vampiristic, feeding on people’s personal and highly intimate information for professional gain. Seriously.

  6. Predating Michel Foucault’s more major Madness and Civilization, or The History of Madness is Madness: The Invention of an Idea (1954, 1962 revised). Foucault, a psychology professor at the time, suggests in this volume that there would be no psychology were it not for madness. Psychology, which endeavors to render all behavior comprehensible, has in madness the conundrum of un-reason to contend with, and to sustain itself on as a profession.

    Of course, psychology is not predicated on biology the way psychiatry is, however this does not mean that psychology is any less guilty when it comes to the oppressing the population of people deemed mad, and, in the process, suppressing freedom of expression. Psychology is certainly guilty in a collaborationist sense. Despite the power struggle between the two professions, psychiatry could hardly maintain it’s hegemony of power without the tacit of support of other mental health professions, including psychology. With psychology, as with psychiatry, you’ve got social controllers who maintain their position by denying it. In both cases, “health” is confused with social control.

  7. Considering the different approach of these mental death specialists I would suggest upon graduating from their respective schools of pseudo -scientific gobbledegook , sanctioned by a fascist government to commit crimes against humanity, that they adopt tattoos applied to their foreheads , say 2 lightning bolts in the center of the forehead for psychologists and 2 lightning bolts on either side of a swastika for psychiatrists. After all both have horrific history of involvement in genocide . Besides they are proud of what they do and at least with the prominent tattoos the people could recognize them whenever and wherever they may appear and greet them with an approach of their own .

  8. A recent study (published in June 2016) that tested “the MEND protocol” (that included dietary guidelines, meditation practice, yoga, etc.) found that Alzheimer’s patients who had had to discontinue work (due to the disease) were able to return to work, and those struggling at work were able to improve their performance, etc. The study was evaluated using MRI scans and neuropsychological testing. The link to the study (titled “The MEND Program Shows Promise for Reversing Cognitive Decline”) is here:
    http://www.drperlmutter.com/wp-content/uploads/2016/06/Rev-Cog-Dec-2-on-6.13.16.pdf
    It is also interesting to note that in this study, most of the subjects had at least one copy of the APOE4 allele (a strong genetic risk factor for Alzheimer’s), demonstrating that the effects of genes can be combatted.

  9. It would be interesting to see a similar study in the USA. As someone with an undergraduate degree in psychology who went into psychiatry, I have seen something of both sides. (Also my mother was a psychologist and my father a psychiatrist). One very popular course in undergraduate psychology was “biological psychology.” The push by psychology to gain prescription privileges suggests that psychologists here may hold many of the same biological biases that some psychiatrists do. In my psychiatric training almost all my teachers and supervisors were psychoanalysts. That is unlikely to be the case anywhere in America now (I was in my residency in the later 80s) but it speaks to the historical importance of psychological understanding to psychiatry.

    In general, I tend to think of what internal stresses my patients might be struggling with, what is going on in their life (external and relational stress), and what constitutional strengths and weakness they may have. I prefer to recommend lifestyle changes, meditation, yoga, a good sleep schedule, and a healthy diet. But if someone is suffering enough, I will do whatever I can think of to help. It doesn’t really matter what. Sometimes it is talking. Sometimes it is medicine. Sometimes it is both.

  10. I will do what cognitive dissonance dictates . Help I’ve been brainwashed but I need to help you so I can make payments on my summer vacation home . It doesn’t really matter what. Blah! Blah! Blah! softly with authority . Or Toxic drugs with even more authority and even softer . Personally I’ve never had the courage to try them . I’m so sane and caring and open minded . Sometimes it is Both . I can’t thing of anymore they won’t let me . I feel like a character in a Martin Short skit.