Demystifying visit to a psychiatrist

Consider the following facts:

• » One in five adults have a diagnosable mental disorder.
• » One in four families will have a member with a mental illness.
• » Less than one-third of the children under age 18 with a serious disturbance receive any mental health services.
• » Depression is the third most common illness in the world.

Despite overwhelming evidence that mental illness is very extremely common, visit to a psychiatrist remains something of a mystery and a taboo. People are afraid to go to a psychiatrist because they feel that psychiatrists are strange people who do strange things.
He/she looks into your eyes and knows all the secrets of your heart.
He/she makes you lie down on a couch and takes notes.
He/she may even hypnotize and know things, which you don't want to tell.

Well, nothing of the sort happens, psychiatrists employ scientifically proven therapies and not any witchcraft. Following is an attempt to give an overview of the various therapies/techniques commonly used in treatment on mental illness.

Psychotherapy

This is the most commonly used technique.
The first step is VENTILATION that is, the patient expresses all his/her distressing/stressful experiences/emotions. The person is able to tell all his conflicts to a professional person who is able to understand them better than his friends/relatives.

An active listening by the psychiatrist in itself is a very good therapy (much like the confessions to a father in the church).

The second step is when the patient, with the help of the psychiatrist looks into his/her patterns of coping with stress. He tries to introspect into his own emotions, which is called INSIGHT in the technical language.



The third step is when the patient with the help of the therapist decides to change the thinking and behaviour, which he feels, are not able to help him/are impediments to handling a stressful situation.

Cognitive therapy
The psychotherapy deals more with emotions and support in stress whereas cognitive therapy mainly works with your faulty beliefs. Cognitions are learnt beliefs and thoughts, which every person has as a part of his/her personality.

They are the slogans or principles that we use to deal with different situations in our life. Few slogans are healthy and help in coping well. Some of the slogans on the other hand are unhealthy, irrational prejudices and biases. It is these irrational beliefs that the cognitive therapy aims to help.

Behaviour therapy

Here the focus is on behaviour and not emotions and thinking. Some particular behaviours like,
Fear of blood and injection so the person faints at the sight of them.
Fear of crowded places (known as claustrophobia) so that he cannot travel in a bus.
Feels everything is dirty and has germs and washes her hands repeatedly (Obsessive Compulsive Disorder).

These behaviours are very distressing to the patient and behaviour therapy aims at helping these by a few techniques.

I. Relaxation: the patient is taught to relax his body and mind so that he doesn't have palpitations and sweating on seeing blood.

II. Gradual exposure and systemic desensitization: the patient is gradually exposed to the feared object so that he is desensitized to it e.g. visiting increasingly more crowded rooms (in cases of claustrophobia).

III. Exposure and response prevention: patient is exposed to dirt and not allowed to perform the behaviour e.g. washing hands.

All these techniques are used under the guidance and supervision of a specialist.

Psychoanalysis:

Freud introduced this technique. It is a very long-term therapy, which requires many months (and perhaps the one requiring a couch and the doctor listening and taking notes..!), and so is not commonly used.

It involves talking to the person and thereby understand the childhood experiences and conflicts, which might have resulted into the present illness.

The patient also understands about the childhood conflicts and this is called gaining insight into his/her emotions.

Hypnotherapy

Perhaps the most mysterious sounding of all the techniques used but it in no way is witchcraft. It just involves taking the person to a special state of consciousness (with his consent), where it is possible to look into the unconscious processes of the mind. The advantage is that usually operating defenses, which prevent the true insight into the conflicts/causes, can be overcome.