MY PERSONAL JOURNEY

My Personal Experiences Of Personal Psychotherapy

My Personal Experiences Of Personal Psychotherapy

At first sight, comment from a general psychiatrist as to whether or not personal psychotherapy is necessary for the training of a psychiatrist would seem as inappropriate as for a Presbyterian minister to decide whether the 'laying on of hands' is essential for the ordination of a priest. In both situations, objective facts about efficacy are hard to establish, and historical tradition transmitted by meaningful ritual is of considerable importance. It could be argued, therefore, that this debate should be confined to those who are familiar with these traditions from the inside. However, on closer reflection, there are several reasons why this important matter should be considered by general psychiatrists and not restricted to a psychotherapist's debate alone. Clients and counsellors kept diaries about significant aspects of therapy sessions, while clients also kept diaries about new and different experiences in other contexts in their lives.

Firstly, this unresolved debate still causes anxiety for trainees, is divisive between the 'haves' and the 'have nots', and any psychiatrist may be asked for advice. Furthermore, although these peer group discussions may be maximal in London, where psychoanalysts are thick on the ground, they are also heard elsewhere. One Scottish trainee, for example, said that the current controversy was whether or not a 'five star' analysis was necessary (i.e., London based) or whether the Edinburgh package was also acceptable. How complicated-as if a trainee has not enough on his slate already, in coping with mental handicap and research experience, without having to weigh up such imponderables as the correct pecking order between different psychotherapy trainings. Most counselling paradigms presume that the client then implements these changes in the context of everyday life with or without the therapist's help during an 'action stage' of therapy.

Secondly, because general psychiatrists will have an interest in recruitment to their sub-specialty they should be aware that for some trainees a personal analysis is the first step away from the rough and tumble of an acute admission ward to the more selected Psychotherapy or Child and Adolescent Psychiatry clinical settings. There is a risk, more-over that such training may unwittingly perpetuate the erroneous belief that psychotherapy is only for the psychotherapist, and that the appropriate integration of psychodynamic, behavioural and biological models (none of which is totally explanatory) should either not be attempted at all, or be dismissed as vague eclecticism.

Thirdly, a general psychiatrist should know how a psychotherapist is currently trained and have a working knowledge of the theoretical and practical training this psychotherapy colleague has undergone. Empathy with "being analysed", and understanding the influence of this training on subsequent c1inical attitudes will certainly facilitate communication.

It is an advantage for all psychiatrists to obtain some knowledge of psychodynamic psychiatry and to have insight into their own style of personal interaction. The ways in which this more limited personal insight can be gained are multifarious. Regular group or individual psychotherapy supervision may provide this opportunity by discussing ...