Since I last wrote about the negative impact of psychoanalysis on psychiatry, I have realized more kinds of insidious fallout for the profession.

  • Let me call it ShrinkThink: Even when attempting to explain the effects of drugs on psychiatric symptoms and disorders psychiatrists all too often seem to make huge leaps in logic, almost akin to the “loose association” we might cite as evidence of thought disorder associated with schizophrenia. Could such thought process have evolved from training in psychoanalytic theory?

  • The zombie psychoanalytic couch: The New York Times now entitles a blog about psychotherapy matters “Couch.”

  • Long is better than short: The myth that “long term” psychotherapy betters shorter treatments persists only in psychiatry.

  • Exclusion of family: Psychiatrists still voice reluctance to involve in treatment the really important people in the lives of their patients. Psychoanalysis still focuses treatment on the relationship between the patient and the analyst risking damage to the family and failure to address critical problems.

  • Everybody needs therapy: Can you imagine a psychoanalyst telling the prospective patient after the first encounter, “You don’t need treatment. You have no neurosis or psychosis.” It does not happen.

  • Knowing the patient: Imagine your gastroenterologist or orthopedic surgeon scheduling two 50 minute sessions a week for an indefinite period so they can “get to know you” before prescribing treatment or replacing your knee. Only in psychiatry.

  • Psychoanalytic worldview: Where else in medicine do physicians extrapolate the principles of a treatment modality to “explain” (really to understand) all that happens in the world, all human behavior. Psychiatrists owe to psychoanalytic theory the mythical assumption that the way everyone responds to anyone else grows out of “transference.”

  • Awkward encounters: Without the influence of psychoanalysis would psychiatrists worry about how to act when they encounter a patient outside their office?

  • Medical psychotherapy: The notion that one must graduate from medical school in order to attain competence as a psychotherapist almost surely evolved from the medical origin of psychoanalysis.

Like psychiatry historian Edward Shorter recommend in this recent article, we should "Abolish psychoanalysis from the psychotherapy training of residents. (It is like making a course in astrology requisite for the training of astronomers.)"

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