Hi Marie,
You can emphasize whatever you choose as a psychiatrist....be it medications or therapy. In your private practice, no one will demand either. It will be primarily up to you. I know plenty of dynamically-oriented psychiatrists that emphasize primarily long-term therapy with minimal psychotropics. Conversely, I know plenty of psychiatrists that do the opposite.
You could certainly consider psychology, but since you're already in med school, this makes little to no sense. Your salary will be much higher as a physician, and your opportunities much broader. The outlook for psychiatry is very bright, with a relative need nationwide, espeically in certain specialties (child). The new medication classes, along with research and soon-to-be approved clinical procedures such as transcranial magnetic stimulation, make the future exciting and bright. You state that you're interested primarily in therapy and counselling. You'll likely find that this, combined with your medical knowledge and medication armament will be a nice blend that helps patients get better quicker and with better outcomes. This is not to say, however, that you could not choose to emphasize primarily therapy. You'll also likely enjoy CL psychiatry, where you'll be interacting with the medical team and family to help them both deal with difficult prognoses, conditions, and the like from a supportive standpoint.
As for the "blood and guts," it's part of med school, and makes our experience unique in that respect. You'll be glad you have the blood & guts knowledge when the times arise. There are lots of medical specialties that are minimum blood & guts. You'll get through it like everyone else, and be a better doctor for it.
Congrats on you admission to medical school. Take things slowly; many who strongly belive they'll enter a certain specialty change their minds and alter their opinions. Good luck.
