I think that as opposed to switching IM subspecialties or something similar, switching from Psych may feel or be perceived as more difficult because you're further removed from the internal medicine-y aspects of healthcare, but this is likely to be very person-dependent. That you've had a longstanding interest in CL suggests that you've always had an inclination, if not aptitude, for the non-psych aspects of medicine, so as long as the drive is there I think it shouldn't be too difficult for you. I've known a handful of attendings who have switched specialties and they all stressed determination and a patient/understanding family situation as the keys to this transition. Mind you, there's going to be a pretty large income hit that you'll probably never fully recover from unless you end up doing EM in a rural area, interventional pain, or some other very highly compensated field, but if you're truly unhappy it's worth it. And as somebody in your other thread mentioned, your previous training in Psychiatry will make you highly sought-after no matter what field you wind up switching to.
