Thread by @psychunseen

1/ Practicing medicine involves a relationship between physician and patient. Psychiatry even moreso due to the focus on symptoms and internal experiences as opposed to objective/external signs which ironically is a frequent criticism of the field from a diagnostic standpoint.

https://twitter.com/eliotmuir/status/1811061913586893172

2/ The perspectives of doctors, patients, and families are distinct. One is not necessarily more "deep" than another and each contributes something, reminiscent of the parable of the blind men and the elephant.

3/ Sometimes those perspectives--whether physician, patient, and/or family--are distorted. Certainly in psychiatry, it's recognized that cognitive distortions and delusions can be a challenge.

4/ Whether in formal psychotherapy or not, there should be collaborative work (patient informs physician and physician informs patient) towards understanding and potentially seeing things in a different light.

5/ Physicians do indeed spend countless hours with patients. Due to the intimate nature of what's discussed (again, even moreso in psychiatry), it can often amount to substantially more time spent discussing issues than what's shared with any other person.

6/ The claim that a "medical degree" doesn't add to an understanding of mental health/illness ignores that time spent "sitting" w/ patients. Despite related claims re: the so-called "biomedical" approach, that's not really how MDs, and esp. not psychiatrists, approach patients.

7/ An oncologist doesn't only bring to the table expertise about the biology of cancer cells. She brings the experience of being with patients who have suffered its effects and the families who have mourned their death.

8/ Conversely, a psychiatrist doesn't only bring experience sitting with patients. She brings her own lived experience with mental health issues. She brings her knowledge of the therapeutic and adverse effects of medications as well as the many "medical" causes of mental illness.

9/ That experience--rather than a medical degree per se--is indeed a form of "authority" and "expertise." It may not be the be-all-and-end-all, but in terms of making a difference, it's something and in some cases everything.

@threadreaderapp unroll please