What is Psychiatry?

What is Psychiatry?
According to the American Psychiatric Association, psychiatry is a field of medicine which diagnoses, treats and prevents a wide wide range of psychological disorders. 

What is a psychiatrist?
Psychiatrists must be medically qualified doctors who have specialised in psychiatry, which is different from most other mental health professionals. Psychiatrists can therefore prescribe medications as well as using psychological treatments. (NHS)

What conditions does psychiatry diagnose and treat? 
A non-exhaustive list via NHS

• anxiety 
• phobias 
• obsessive compulsive disorder (OCD)
• post-traumatic stress disorder (PTSD) 
• personality disorders 
• schizophrenia and paranoia
• depression and bipolar disorder
• eating disorders, such as anorexia and bulimia
• sleep disorders, such as insomnia
• addictions, such as drug or alcohol misuse

Diagnosis

Due to their medical expertise, psychiatrists are able to perform both psychological and medical assessments to provide detailed analysis of a condition. Psychiatrists understand the intricate link between physical and psychological illness and take time to evaluate family history of illness to get a very complete understanding of patient issues in order to develop treatment plans. 

Treatment
Psychiatry takes form in a wide ranging variety of treatments. Different therapies can be combined with medications depending upon the individual needs of the patient as per the diagnosis.  

Depending on the severity of the condition psychiatry can take a couple of sessions, or be an ongoing process of treatment that can take several years. One of the biggest criticisms aimed at psychiatry in the past has been that treatment can potentially go on indefinitely, which can obviously be very expensive and time consuming for both the patient and medical services. 

Examples of treatments include psychotherapy , psycho-social interventions or Electroconvulsive Therapy ECT. 

Examples of medications include; antidepressants (depression, panic disorder, PTSD, anxiety, obsessive-compulsive disorder, borderline personality disorder and eating disorders), sntipsychotic medications (delusions/hallucinations, schizophrenia, bipolar disorder), sedatives and anxiolytics (anxiety, insomnia). The general idea of medications is to attempt to correct chemical imbalances in the brain that are considered to be the cause of psychological dysfunction.

Couples Therapy: Addiction

Addiction is a worldwide epidemic. Sugars, nicotine, gambling, pornography; we humans appear to have something ingrained within our nature that makes us become compulsive, and once the habit becomes set it is incredibly difficult to move away from it. Add chemical addiction to a behavioural habit and you have a recipe for a life-threatening condition.  

The addicted individual must genuinely want to make a change. It’s a cliche we have all heard, but one very true and the first step toward making any kind of change. How one fosters that motivation is the million-dollar question. Encouragement, education, doctor’s warnings, bodily dysfunction, scientific facts, threats - each have varying levels of success. Many will just take time to process all the information until they find a point in their life where they just feel ready to change, or sometimes they sadly never will.

Hypnotherapy can’t work without motivation, and neither will prescribed medications.

With couple’s therapy in addiction it is much the same thing. There needs to be motivation to work, but if both people buy into the idea of being free from addiction then the added support that brings through companionship in the journey can be priceless. You want to be free from addiction for yourself and so your partner can be free and healthy too. Often doing something for someone else’s benefit has an even stronger motivating force.

In an ideal world couples will support one another and promote positive change, although sadly this is not always the case and is why professional help is often sought.  

Partners can negatively affect us. Imagine you are trying not to eat biscuits while your partner consumes them in front of you night and day, leaves packets around the house and talks about them non-stop. The routine of consuming sugars is triggered within you constantly by the numerous sensual and visual cues making it all the harder to escape from.

Jealous partners who can’t quit themselves try to make themselves feel better by dragging their other half down with them. At heart we like to share in our addictions, its part of the disease.

A non-addicted partner can also have a negative influence while trying to be positive. Maintaining standards that are too high or having an attitude that does not aid a progressive environment is common. Frustration in progress can manifest with comments like; ‘You will never quit!’ which can leads to self-fulfilling prophecy. Incredulous reactions; ‘I can’t believe your still drinking after what happened to your father!’ ‘You’ve just had a heart attack!’ We hear ‘No’ and our subconscious minds rebel.

That said being perfectly supportive often isn’t enough either – so what is the right approach truly?

The NCBI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851021/ report that couples therapy statistically works better than individual therapy. This does not surprise me, but it is fascinating nonetheless. From personal experience I have seen favourable results from couple’s therapy in the smoking cessation clinic I run, but why does this happen?

We are social creatures after all, so when we do things together they become more powerful experiences. The reflective period post session becomes greater due to the interactive nature of being able to share upon what transgressed. Perhaps witnessed therapy becomes sessions we cannot escape the truth of.    

The NCBI report talks about addiction being not an individual problem but a family one, where our social interactions reinforce addictive behaviours. Thus by having Behavioural Couples Therapy the problem is being targeted at its root in hope to making the lasting changes we aim for.