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Anyone practice any integrative psych, even if it's prescribing DHA, SAM-e, diet?
I think there's still a distinction made between them.Integrative is such a loose term. What the hell does it mean? Non-medication? Isn't therapy just that? What was formerly called complementary/alternative medicine? Herbal? Acupuncture? Hypnosis?
Integrative is such a loose term. What the hell does it mean? Non-medication? Isn't therapy just that? What was formerly called complementary/alternative medicine? Herbal? Acupuncture? Hypnosis?
Integrative is such a loose term. What the hell does it mean? Non-medication? Isn't therapy just that? What was formerly called complementary/alternative medicine? Herbal? Acupuncture? Hypnosis?
I consider all of these to be part of medicine.'It emphasizes principles that may or may not be associated with CAM, such as,
1. The natural healing power of th eorganization
2. Whole person medicine
3. The importance of lifestyle
4. The critical role of the doctor-patient relationship
Integrative psychiatrists have many more options to offer patients than their conventional counterparts. As alternatives to drugs, they can recommend dietary changes, dietary supplements, botanical remedies, exercise, relaxation training, a variety of mind/body therapies, and new forms of psychotherapy that can teach patients to be optimistic and to identify and restructure habitual patterns of thought that lead to negative moods and behaviors."
Integrative Psychiatry by Daniel Monti and Bernard Beitman
I consider all of these to be part of medicine.
I don't agree with the "integrative" distinction.
Totally agree. I consider these things to be "Stand of Care" and recommend these treatment options to all my patients. For example, I see a lot of ADHD and I always recommend exercise, avoiding artificial food dyes, and Omega-3's. I recommend similar options (depending on the disorder and research) to other disorders including bipolar, depression, and anxiety. I do, however, tell them the evidence and what I know from the literature, which sometimes goes like "although the evidence is not that robust, it (insert recommendation here) has been shown to help some patients and I would therefore recommend this for you to try."
A good example digtl about this artificial distinction IMO between "supplements" and medication. Many people who are more holistically minded recognize that food and medication are on a spectrum, and that "natural" doesn't mean safe, any more than FDA approved does.
I spent the last month on an "integrative" or "functional" medicine rotation.
Exactly. I like to use Lithium as an example. As a "natural" substance, these people typically can't make much of an argument against it. Then, if they're EtOH or tobacco users we talk about how EtOH is synthetic and tobacco is "natural". Then we talk about things like lead and other "natural" poisons. By this point (maybe with a few days to think about it), many people come around...
I spent the last month on an "integrative" or "functional" medicine rotation. Here's what I found:
..
I like to ask the diehard "natural" folks if they would agree to wipe their butts with "natural" poison ivy.
These guys routinely order labs for vitamins, folic acid, D, B, mag, etc
This is a great thread. My limited experience overall is that there are a subset of patients who are simply biased against a traditional approach such that they'll want alternative therapies regardless of what you tell them. I'd like to think the future of medicine is integrative, utilizing the best evidence possible to find the best fit for an individual. However, it seems like practitioners of "integrative" medicine and the patients that flock to them are just as separatist as their counterparts.
I went to one of the integrative presentations at APA last week. I really liked the first half when they were talking about vitamins and nutrition. I felt the evidence was well-presented and that I learned something. But I didn't much care for the second half. Probably because it started with a guided meditation and for some reason, I just really don't like those. And then they were talking about EFT and did an EFT demo. And it just seems so hokey to me. I'm not sure what I think of the so called energy therapies. I mean, it's not that I think it categorically doesn't work or can't work . . . I guess I just haven't been too impressed by the kinds of people who seem to gravitate toward them. And maybe their tendency to disparage and poo-poo more traditional psychiatry is part of that impression.
You know, I really have no problem with traditional shamanic methods of healing. I don't know a lot about it, don't particularly want it done to me, but I'm willing to believe they have merit. I don't think believing in spirit guides or totem animals or different planes of existence that you can travel to in trance states is any wackier than someone believing Jesus died for their sins. I do believe that the world is wider and more magical than many are willing to accept.
What I do have a problem with is performing shamanic/traditional/energy healings and calling it psychiatry. I didn't learn how to do soul retrieval in residency and it wasn't on my board exams. Now, I'm sure there are mental health professionals who have studied these methods in depth and are perhaps qualified to hang shingles as traditional healers. But doing it within the context of a psychiatric practice really muddies things, I think.
my favorite was a talk i went to on spirit release therapy (the speaker was a psychiatrist). my friend asked during the Q&A 'how do you release spirits' and the psychiatrist said 'psychotherapy with spirits is much easier than with humans. you just reason with them they'd be better off if they left and they listen.' all with a straight face... i had to bite my lip to stop myself from laughing!
I met a psychiatrist once who asserted that many, if not most, cases of bipolar disorder were actually cases of spirit possession.
Most wished me the best of luck in a field "corrupted by big pharma" who just want to "medicate the world" and said I'd have a tough time in psych unless I just wanted to throw meds at people. I said I'd be fine. Hahaha.
As a patient I've personally found that the majority of 'Big Pharma conspiracy, you don't need to be on medication' type practitioners come across as being far more interested in pushing their own private agenda than they are in actually providing proper treatment. Same with patient advocates, who advocate in the extreme that absolutely no one should be place on an involuntary treatment order, ever, regardless of the danger they might present to themselves or others (because clearly even the most far end of the Schizophrenia spectrum can be managed with kisses and huggle f*cks ). This sort of extreme black and white, 'it's us against them' type of thinking and practice bothers me immensely from the point of view that I've actually seen it result in death.
And you sound like you'll do just fine in Psych, you seem to have a good, balanced attitude towards stuff.
*goes back to lurking and reading*
I like to ask the diehard "natural" folks if they would agree to wipe their butts with "natural" poison ivy.
Zenman - If you're interested in the practices of Shamanism, you might like to take a look at shadow work, if you're not already familiar with it.
What a weird-ass thread this has become.