Philosophy of Psychiatric Practice

Western thought tends to be analytical, focusing on objects and their attributes. Western medicine tends to focus on symptoms and the diseases they point to. This can cause a tendency to forget the entire system and how things fit together. This contrasts the biopsychosocial approach described by Engel. I view psychiatric symptoms (difficulty in controlling feelings, thoughts, or behaviors) as resulting from pushing the body, psyche, and/or social role to an extreme. These symptoms are a sign of imbalance in these three interconnected systems and not just a problem in itself.

Because of this viewpoint, I am wary of simply using a targeted medication or therapy in addressing a symptom. As a physician and psychiatrist, I do use these tools, but encourage my patients to recognize their limitations. I also encourage continued monitoring and seeking the "big picture." If someone has a headache, and an aspirin makes it go away, are they cured? Perhaps, but if they keep getting headaches every month you need to examine if biological (premenstrual hormones), psychological (anxious personality), or social (paying monthly rent) factors are at work. You don't want to just keep taking aspirin, even if it "works."

This approach takes time which few people want to spend in the fast-paced American culture. It requires time, paying attention to oneself - one's body, one's mind, and one's relationships. And, there are no "solutions." Seeking improved physical, mental and social health is an ongoing process. A good healer may be able to help you identify your personal processes and where they go out of balance, but in the end understanding and changing the self are skills each of us continues to work to improve.