A psychoanalyst does psychopharmacology

Abstract

In the same practice setting a psychoanalyst does not practice psychiatry much differently than his colleague without analytic training. The impact of the economic environment can determine practice behavior more than differences in background. Subtle and not-so-subtle pressures, particularly from third-party payers, create a push to remove a symptom or resolve a crisis in the cheapest and fastest way possible. This pressure leads to a preference for the use of medication and supportive-directive types of psychotherapy in the absence of any evidence that they are truly more effective, as judged by a broad and long-range benefit to patient and society.