What is the difference between psychiatry and psychology?
Historically,
the sciences were considered a part of philosophy called natural
philosophy, as they pertained to thinkers concerned with the state of
nature. Psychology was that part of natural philosophy associated with
human nature. As philosophers of human nature were primarily concerned
with actions that could be judged as right and wrong, psychology was
considered a moral science. This was the purview of philosophers who were
contemplating the normal range of human behavior. Alternatively, abnormal
behavior, more commonly known as psychopathology, was generally the
purview of physicians. Those physicians consisted of either neurologists
or general practitioners whose responsibilities included the general
medical care of patients committed to asylums for the mentally ill. No
special training existed in the diagnosis and treatment of mental
illness. Expertise was therefore derived primarily from exposure to those
types of patients and not by any specialized training. When science
separated from philosophy with the introduction of the experimental
method, the field of psychology also began to adopt an equally
experimental approach. Psychology retained its status in the university
as an academic discipline devoted to understanding how human behavior and
the mind worked.
Freud, trained as a neurologist, was the first physician to develop and
describe a method of therapy whereby the patient said whatever came to
mind - called free association. The therapist would listen critically and
link various dreams, memories, and stories that the patient related to
him or her and provide an interpretation for the patient as to the
unconscious meanings of the patient's narrative. Through these
interpretations, the patient developed insight, allowing the patient to
make changes in both his or her attitudes and behavior so that he or she
could be relieved of pain and suffering. Freud coined this method
psychoanalysis. This was the beginning of modern psychotherapy. Freud was
instrumental in expanding the treatment of mental illness in such a way
as to take it out of the asylums and put it in the office. He also
strongly believed that although psychoanalysis required very specialized
training a medical degree was not required in order to learn and practice
the technique. Thus, the door was opened to psychologists becoming
clinicians rather than solely scientists and philosophers. Since that
time, universities and professional schools of psychology have expanded
to train psychologists to become clinicians. Psychology students can
choose a career track in either research or the practice of clinical
psychology. A clinical psychologist typically has undergone 4 years of
undergraduate education and 4 years of graduate education in psychology,
followed by a 1-year internship in a mental healthcare setting, treating
patients under the supervision of a senior psychologist.
Psychiatrists have a radically different educational path, having grown
as a specialty out of the asylum system where physicians took
responsibility for the general healthcare of the mentally ill who were
confined to asylums. Psychiatrists begin studies in human anatomy and
physiology as medical students. Graduating with a medical degree and the
same educational background as all physicians, psychiatrists spend a year
in an internship that may include psychiatry but must include medicine or
some other medical rotation and neurology. After internship one spends an
additional 3 years as a resident physician, treating patients in a
variety of settings under the supervision of a senior psychiatrist. As
physicians, psychiatrists are licensed to prescribe medications just as
all physicians are. However, because of their specialty, they develop a
singular expertise in using medications to treat mental illness.
