Varied Perspectives in Contemporary Psychiatry

Biologically based approaches, which predominate today, will see most problems in the light of biology and neurotransmitters, thus relying heavily on medication. This approach is essential in conditions that are heavily influenced by biology, such as schizophrenia, psychosis, bipolar disorder and certain forms of depression and debilitating anxiety. Western medicines certainly have their usefulness as well in less severe forms of anxiety, depression, stress states and ADD/HD.

However all symptoms takes place within the context of a whole person in their whole life. Many problems that people seek treatment for, such as depression, anxiety, trauma, feelings of alienation and disconnection from self and others, addictions and relationship problems cannot be just seen as a “chemical imbalance” and medicated away, but need to be explored, understood and healed.

Psychoanalytically oriented approaches are heavily influenced by psychodynamics and see symptoms as the result of inner unconscious process that needs to be resolved primarily through ongoing intensive psychotherapy. In a psychoanalytically informed psychotherapy, underlying emotions, desires motivations and conflict are uncovered and explored.

Humanistic psychology focuses on the healing impact of a warm, accepting human relationship between doctor and patient that is based on unconditional positive regard. Although expertise in psychology is required, the focus of the doctor as sole possessor of knowledge and the patient as passive recipient is replaced by a search for the patient's inner strengths and capabilities for change within themselves. The humanistic attitude believes that the doctor patient relationship can bring out the potential for self understanding, self care, maturation and discovery of meaning and purpose in life. There is less focus on "psychopathology " in the patient and more regard for the natural healing capacity that can be wooed by the therapeutic relationship.

Transpersonal psychology continues and expands this approach by drawing on the spiritual dimension of the human psyche and focuses on traditional healing practices from the East and West. These encourage moving past self-preoccupation and getting “out of the self” through methods such as meditation and study of traditional wisdom. The goal is maturation, authentic self realization and developing a compassionate response to oneself and others. This approach fosters direct “peak” experiences through altered states of consciousness, bodywork, time in nature , and formation of healing communities.

Holistic approaches to the treatment of stress, depression, anxiety and emotional problems focus attention on lifestyle, values, diet and prescribe activities such as yoga, exercise, prayer, meditation and various herbs and supplements. Recommendations for alternative and complimentary treatments such as acupuncture, massage and hands on energy healings are also included in the holistic approach.

An Integral approach gives everyone a seat at the table.

The question becomes, “What does this particular person, in this particular set of circumstances need?”.

For some it is a matter of resolving symptoms alone. For others it is about getting down to root causes and moving ahead to the next stage in adult development. It may be primarily a biological, psychological, humanistic or holistic treatment. In most instances a combination of some or all of the above is used. Factors of personality, preference, time and finance are all part of the decision.

It is my initial work, through an evaluation, to facilitate a collaborative approach based on a mutually held view of what is wrong and what would be helpful. A treatment plan is then co-created to address the goals of the patient.


© 2010 David G. Aftergood, M.D. • Please read our Disclaimer