Psychiatry is the branch of medicine concerned with the diagnosis and treatment of mental disorders. A psychiatrist qualifies as a medical doctor and then undertakes further study to become a psychiatrist. People often confuse psychiatry and psychotherapy. This is understandable since both begin with ‘psych.’

The word psyche comes from the Greek word for ‘soul,’ and in many ways this spells out the difference between the two approaches. The original sense of the term psychiatrist was 'physician of the soul.' (see Thomas Keating, The Human Condition, p.2) Today psychiatry, in general, would see mental and emotional symptoms as requiring treatment with drugs. Relating symptoms to a person’s life, or their inner spiritual journey, is generally not part of making a diagnosis.

Whereas psychotherapy emphasizes that persons are responsible for themselves, it emphasizes the ability of persons to go beyond themselves and realise their nature more fully. A psychotherapist is not qualified to prescribe medication.

So there can be a dilemma for the consumer here – the approaches seem so at odds with each other. Do I choose a psychiatrist or a psychotherapist? Again there is no clear cut answer. Common sense must prevail here. There are times when people need drugs and the services of a psychiatrist and times when they don’t. The danger is when we see every human response as a diagnosis. I am often curious why we accept being prescribed tablets for natural responses - such as grief after a death, yet we don’t prescribe medication when people have a big win on the lottery. Or maybe we do, but just don’t hear about it?

For the person who is troubled what is important is that they ask whatever questions they have of their doctor or psychiatrist. The ethical principle of informed consent applies equally to doctors, psychiatrists and psychotherapists. Everybody is entitled to information about the benefit and harm of any treatment, therapy or drug. It is only by weighing up the information that a person can make the right choice for them. Sometimes this will take time and support may be required.

When a person is attending a psychiatrist and wants to go for psychotherapy they should tell their doctor or psychiatrist. Most will be supportive of this. The major difficulty is that psychotherapy is not yet generally available within the public health system in Ireland. So accessing services can involve long waiting lists. An interesting TV debate on mental health in Ireland adresses the wider issues - click here to listen. The alternative is to attend a private psychotherapy practice. The Irish Council for Psychotherapy website has a register of therapists from a variety of disciplines and can be searched by location.

Whatever the challenges you face, what is important is that you get the support you need. There is support available but it may need a bit of shopping around to get just what suits you. So ask loads of questions, and don’t give up till you find what helps you. Even though you may be struggling you are still capable of making effective choices. I pass this encouragement to you from the many people who have told me ‘I am so glad I didn’t give up, even though I often felt like it.’
Please call me with any further questions you may have on 086 8545407 or e-mail me in confidence to This e-mail address is being protected from spambots. You need JavaScript enabled to view it