Psychiatry and therapy are very different types of help and support for mental health issues, and they work together surprisingly well.
Psychiatry is a branch of medicine that works with mental health issues. As a result of the vast amount of research in psychiatry, a directory or manual has been developed called the Diagnostic and Statistical Manual of Mental Disorders or DSM. This contains all the recognised psychiatric conditions and is used by psychiatrists when diagnosing a client and putting together a treatment plan.
Therapy is the study of the emotional and psychological effects on us as individuals. Research to support therapy looks at anything from a one-off extreme experience to the experience of daily life and the different life stages we go through. There are many groups of theories in therapy and each group or discipline has a specific name relating to a specific set of beliefs or hypotheses about how we develop. In each discipline, there are specific treatments or interventions to help us develop our self-awareness and coping skills.
Unless a therapist is specially trained and licensed to do so, they do not diagnose psychiatric conditions or prescribe medication . For this, we need to see a specially trained professional, such as a psychiatrist.
How psychiatry and therapy work together
Medication given by a psychiatrist might help in controlling emotions, but it doesn’t help us to understand ourselves or develop strategies to manage our inner experiences of life. A psychiatric assessment tends mainly to include the symptoms we experience. Such an assessment is mainly for the purpose of medication and insurance claims.
In contrast to a psychiatric assessment, therapy closely explores the causes of symptoms. The majority of therapeutic disciplines believe that our symptoms have their basis in our life’s experiences. Because therapy looks deeper at the areas of our life that are bothering us, therapy becomes an essential companion to our psychiatric diagnosis.
As well as exploring our thoughts, emotions, and behaviours, relationships and preoccupations, a therapist will want to ask questions about:
- What led to the diagnosis?
- What was it like for us to have a diagnosis?
- What was our reaction to the diagnosis?
- How has the diagnosis affected us, our friendships, and our family relationships?
- What do we personally think of the diagnosis?
- How has it been helpful and how has it not been so helpful?
When we have a psychiatric diagnosis, we need to work with a highly trained therapist who is experienced in working with extensive psychological issues and who may be able to collaborate with our psychiatrist. For this long and potentially deeply emotional journey, we need the best we can find and afford.
Therapy can be a more complete experience when professionals who are involved with our life, diagnosis, and therapy work together on a treatment programme. They may work with us in different ways, but if their aim is the same, the help and support they provide will be more effective.
Safety in therapy
Therapists have many considerations that are working in the back of their minds. One of the most frequent when working with a psychiatric diagnosis is our safety outside of therapy:
- What effect will our explorations have after we leave the session?
- Are we in any way at risk?
- Will the explorations cause us further upset?
- Is it the right time for therapy or do we need a little preparation first?
- Are strategies for coping outside of the sessions needed?
With a psychiatric diagnosis, safety is specifically important because of the risk of symptoms flaring up. Exploring our inner life can take us to places we didn’t realize existed. Sometimes we inadvertently open old memories that might make us relive some not-so-great situations. Depending on our background, our therapist might want to talk with us about additional boundaries that will keep us stay safe during and between sessions.
Specific areas a therapist will help us to consider in therapy:
- The support of family or friends can play a vital role while we work through therapy, especially if we have a psychiatric condition.
- Keeping physically safe between sessions might be a conversation we will need to have too. Therapists are likely to be able to talk with us about the best way to manage any potential risk to our physical safety.
- Whatever experiences we have between sessions, our therapist will want to know and will work with us to improve how we manage our symptoms. If our therapist doesn’t know what is happening in our life, it becomes difficult for them to help us.
- A therapist working independently may want to know if other professionals are involved with our treatment and what role they play.
- Other relationships, especially if these are volatile or if they pose any risk to us, are especially important to talk about with our therapist.
- We need to talk about anything that potentially has a risk element to it. For example, self-harm or self-medicating with alcohol or drugs, or issues with eating and food.
Not the end, but the beginning
A psychiatric diagnosis is not the end. It can be the beginning of the journey to a calmer inner world and broader life experiences. Therapy is a crucial key to working with the causes of our symptoms and opening up a future where we can find some contentment and balance in our lives and relationships. While we might have to learn to live with a mental health condition, our life can become a more pleasant place to be if we seek the therapy we need.
To find a therapist, please visit the Psychology Today Therapy Directory.