Who Does What in Mental Health
Psychiatrist- A psychiatrist is a medical doctor who’s specialty is treating mental illness by means of modern medicine. Psychiatrists primarily treat mental illness by prescribing medication. Continued contact with a psychiatrist who prescribes medication is important so that they can monitor the benefits and side effects of those medications and decide if the results are good or if changes need to be made. In many ways, prescribing psychiatric medication is an art, and a good psychiatrist may have to try several different medications in different dosages to find what works best. Because they are medical doctors, they often use other medical techniques in their assessment and treatment of mental illness. Electroencephalography, CAT Scans, and MRIs are occasionally used. In some extreme cases even Electroconvulsive therapy is an option for psychiatrists. Psychiatrists rarely involve themselves in providing talking therapy. It is very common for other mental health professionals to refer clients to a psychiatrist when there appears to be need for psychiatric medication.
Psychologist- Generally speaking, Psychologists have a Ph.D. in the academic field of psychology (as opposed to psychiatrists who have medical degrees). Psychologists have a lot of flexibility in how they practice. Many serve as professors at universities and colleges. Aside from teaching, they also conduct psychological research and write academic papers. Psychologists are also very good at utilizing a wide variety of psychological tests. In many ways, practicing psychologists specialize in diagnostics and client’s who are particularly challenging. Many psychologists do talking therapy and are generally quite well trained in it. As a rule, psychologists do not prescribe medication because they are not medical doctors. It’s common for other mental health professionals to refer a client to a psychologist for psychological testing when there seems to be a need. Many places in the US are flirting with the idea of licensing psychologists to be able to prescribe a limited range of medications themselves.
The Psy.D.- A Psy.D. is really just another kind of Psychologist. It is an academic doctoral degree like a PhD which places less emphasis on research and more on clinical practice. Clinicians with a Psy.D are generally very skilled in talking therapy as well as psychological testing. A Psy.D. is a pretty good choice for any client that is in need of seeing a “Psychologist”; but a poor choice as a research associate.
Psychotherapist- A psychotherapist specializes in talking therapy. They do not prescribe medications and use few psychological tests. Most of the leg work in mental health is done by therapists. Generally speaking, a therapist talks to his clients and uses his specialized insights to help clients better understand things about themselves and the world around them. Therapists can help people with most mental illnesses as well interpersonal relation problems and difficult life transitions. Therapists specialize in helping clients feel more empowered and encouraged. They help client’s sort out how they think and feel about things. They gently challenge people when their thoughts and feelings are inconsistent or don’t fit reality. Ultimately therapists help clients to make better choices and think about things in a more appropriate manner.
Counselor- Counselor is a very generic term. It is often used interchangeably with psychotherapist. In some places anybody can call themselves a counselor. In other places there are licenses for several different types of counselor such as mental health counselor, pastoral counselor, vocational counselor, school counselor, substance abuse counselor, domestic violence counselor, and credit counselor. There are some places where “counselor” can refer to anybody who works with people on various problems by talking with them. In some places “counselors” can work with people who are having life problems like divorce, marital conflict and grieving, but can not work with people suffering mental illness or addiction. Ultimately this term can vary greatly based on the applicable local laws.
Social Worker- Social Workers are a remarkably diverse group. They work in schools, prisons, social service agencies, advocacy groups, hospitals, government bureaucracies, retirement communities, etc. Fundamentally, social workers are there to help other people. This can be one on one service helping a client locate community resources they need or even world wide activism promoting various ideas about “social justice”. In most places, social workers can be licensed and practice talking therapy like a psychotherapist. Though some are clearly qualified to help clients with life problems and even mental illness, that is not the specific specialty of all social workers.
Neurologist- Neurologists are medical doctors who specialize in treating problems with the central nervous system. People most often see neurologists when they have brain and spinal damage or malady. In the realm of mental health, professionals will refer to a neurologist when they think mental health problems are the result of a client having serious organic problems with their brains. Such problems generally come from head trauma, developmental disabilities or substance abuse problems. Viral infections, strokes tumors and plaque build up are also common organic brain problems that can produce emotional, cognitive and behavioral problems. Like any doctor, neurologists address medical problems with surgeries, medications and other medical treatments. Neurologists rely heavily on Electroencephalography, CAT Scans, MRIs and other ways to examine the physical brain. Mental health professionals will often refer to a neurologist when particular symptoms that suggest brain damage are present. A referral to a neurologist is often done “just to be sure” the client is not in medical danger and to “rule out” serious organic problems as the source of mental health problems.
Psychoanalyst- A psychoanalyst is much like a psychologist or psychotherapist that specializes in psychoanalysis. Psychoanalysis is style of talking therapy that is somewhat controversial. It was the talking therapy that started it all back with Freud. Since that time, most other mental health clinicians have evolved new talking therapy treatment approaches, but psychoanalysis continues on only somewhat altered. Where as most talking therapy today focus on helping clients process and grow in the present, psychoanalysis deeply examines a client’s past and tries to resolve hang-ups from formative periods in a person’s life. Unlike more modern psychotherapy approaches which seek efficient improvement for their client’s, psychoanalysis often occurs several times a week for 5-7 years.
Tips for a Better Night Sleep, part 2
Ironically, one of the things that most keeps people awake at night is worrying about being able to get to sleep in time and get enough sleep that night. I can’t tell you how many times even I myself have fallen prey to this irrationally self-destructive mind set. What then are we to do? First we have to fully accept the realization that all the worry we are going through is not really helping us but is more than likely making our situation worse, depriving ourselves of rest. It’s also beneficial to realize that we are likely not going to cure cancer or solve world hunger laying in our bed thinking about it. We have to learn the difference between good contemplative problem solving and wasteful worry. We need to understand that we will be better off facing our problems for real in the morning with a well-rested brain.
Some people have told me that they benefit from a vigorous work out in the late evening. They tell me that the exhaustion they have from exercise helps them get to sleep faster. Others have told me that exercise late in the evening fills their body with adrenalin and endorphins that keep them from getting to sleep. I suspect that these both may be true and that different people have different experiences. Don’t be afraid to experiment a bit with your personal sleep regiment. Perhaps you may want to try working out before bed for one week and doing something very relaxing like a long hot bath another week. Compare and contrast which, if any, changes seem to help or hinder your sleep.
Don’t be afraid to try a sleep mask or earplugs if light or noise keep you up. Light and noise might even be a factor you have over looked because they are so normal and uncontrollable. Some people fear that these masks and plugs make them look silly. Hopefully your partner won’t give you too hard of a time. Other people worry that they will not be able to hear their alarm clock or a fire alarm. Generally these sleep aids don’t limit perception that completely. Try them out on a weekend when it’s not critical that the alarm wake you
Tossing and turning will keep you up all night long if you let it. When we are uncomfortable, it’s natural to flop around seeking for a better feeling position. When you find yourself unable to get comfortable, make drastic changes sooner than later. Don’t waste an hour fluffing your pillow when you could have gotten another one from the closet. If you feel too hot or too cold, change what you’re wearing or adjust your home’s climate controls early on. When you run out of options for improving your situation, stop. If you are going to end up uncomfortable in any position, resign yourself to being uncomfortable and try to shut out the physical experience in favor of the mental. It is possible to sleep in physical discomfort. Throughout history, people have slept on dirt floors, sitting in chairs and even in rain filled battlefield trenches. Remind yourself that the creature comforts are nice, but you can make the best of even the worst mattress and pillow. Settle in for the long haul and lay still.
What we consume before we go to bed is important. Be mindful not to eat and drink things that are going to necessitate going to the bathroom or which will give you heartburn. Choose only foods that sit well with you and won’t upset your stomach. By all means, avoid sugar and caffeine. Foods that are known to contain the chemical tryptophan have long been thought to induce drowsiness. More recent studies seem to dispute this. Rather, large heavy meals rich in carbohydrates are the true source of Thanksgiving drowsiness. Though a rich heavy meal may induce drowsiness, it’s not a healthy prescription for a bit of sleep. Warm milk is another home remedy that has pretty much been debunked. Perhaps it does still have value as placebo. If you really believe that turkey sandwich and glass of milk will help you get some Zs, they just might.
Stretching a bit when first lying in bed can help a great deal. I’m not talking about the kind of stretching we do before a work out, but more of the stretching you see a cat do where they extend their arms and legs and arch their backs. This stretching relaxes the body as a whole as well as loosening us up so that our sleeping position will feel more comfortable
Last but not least, yawn. Yawning has a surprisingly beneficial effect on the human body in terms of preparing for sleep. It’s natural for many people to attempt to cut their yawns short. If you need help getting to sleep, let your yawns last for as long as comes naturally. There is a strange psychological and somatic aspect of yawning which people say is “contagious”. Watching other people yawn has been proven in the research to induce yawning. Even thinking about yarning or visualizing others yawning can make you yawn. Even faking a yawn can often produce a real yawn.