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Psychotherapy
1. PSYCHOTHERAPY
Dr. S. Krishnan MBBS, MD, DPM, DIP.NB,MNAMS
Associate Professor of Psychiatry
Mo-IN-Charge, Holistic and Stress Research Clinic
Department of Psychiatry
Medical College, Thiruvananthapuram
2. Definition…
• "Psychotherapy is the treatment, by psychological
means,
• Of problems of an emotional nature in which a trained
person deliberately establishes a professional
relationship with the patient
• With the object of
• (1) Removing, modifying, or retarding existing symptoms
• (2) Mediating disturbed patterns of behavior, and
• (3) Promoting positive personality growth and
development."
Woolberg L, The Technique of Psychotherapy, 1977.
3.
4. Psychotherapy
• Should be a regular part of Psychiatrist’s
treatment schedule
• Very few budding psychiatrists get training
• Most training programs end up as dramas or
theoretical sessions
5. Misconceptions
• Psychotherapy is THE treatment
• Psychotherapy is not a treatment at all
• Psychotherapy does not need training
• With the understanding of the neurobiology of
psychotherapy, psychotherapy has become a
valid treatment
• Psychotherapy produces the same changes in the
brain as pharmacotherapy
• And many more…
6. Psychotherapy
• Have a diagnosis
• Is there an indication for psychotherapy
• Does the patient fits well into the paradigm?
7. Following steps
• General introduction to psychotherapy
• Guideline to initiate practice
• Guideline to what you should be prepared to
face and do
To open or to close
the door?
12. Who can really be a psychotherapist?
Adequately trained and certified
• Psychiatrist
• Psychologist
• Social worker
• Nurse practitioner
• Physician assistant
• Minister, priest
Untrained persons not tested for competence!
• Anyone can call themselves a “therapist!”
14. Psychotherapy
• Fellow travelers
• Engage in personal therapy
• Be supportive
• Have and teach empathy (Hyperempathy!!!)
• Let the patient matter to you
• Acknowledge your limitations and errors
• Have a new therapy for each patient
17. The present – use it, use it, use it
• Hear with eyes and see with ears
• Working through issues in present
• Frame ‘present’ comments carefully
• What lies have you exchanged
• Be real