Dr. Carole Lieberman

We continue with Dr. Carole.

Are there any benefits to just doing medication visits? For example, it is less expensive for the patient to see a psychologist or other psychotherapist for regular therapy appointments.

If a psychiatrist and a psychologist (or social worker or MFCC) work closely together, in the same office or same clinic, and have regularly scheduled meetings to discuss the cases they have in common, they could, theoretically provide good treatment to a patient, with less overall cost. However, in the real world, this doesn’t happen as diligently as it should. Regularly scheduled weekly meetings to discuss cases become five-minute telephone calls every six weeks, if that.

On the other hand, psychiatrists end up medicating a diagnosis rather than getting to know the whole person and have to rely on the psychotherapist’s and patient’s reports. What are other drawbacks to this and why have you chosen to do psychotherapy as a psychiatrist?

It is extremely difficult, if not impossible, for a psychiatrist to medicate a patient properly if he or she does not get to know the whole person. A patient is not the sum of all his side effects. Indeed, a psychiatrist, seeing a patient once a month for 20-30 minutes, cannot develop a ‘therapeutic alliance’, enough rapport and trust for the patient to disclose his scariest or most embarrassing symptoms or problems. And, ironically, such infrequent short visits cannot assure compliance with the very medications the psychiatrist is pushing… I mean, prescribing.

All the recent brouhaha about antidepressants ‘causing’ patients to become suicidal is not the fault of the antidepressants themselves, but rather the fault of this new laissez-faire treatment model, where psychiatrists are not keeping close enough tabs on their patients, and not talking to them about how they feel and why. Some of these antidepressants have been around for years. It’s not the antidepressant that’s changed for the worse, but the psychiatrists.

How does being a psychiatrist (having medical training), help you as a psychotherapist?

Though some may wonder what medical school and medical internships in hospitals have to do with practicing psychotherapy, in fact, it is useful in many ways. It enables the therapist to treat the whole patient – combining knowledge about mind and body. Oftentimes, psychological problems manifest themselves in physical ways, symbolic of the underlying problem. For example, it is useful to know how to distinguish someone’s chest pain from ‘pain in their heart’ caused by the loss of a loved one. Although I do not treat these physical problems, I know enough to decide when to refer to a specialist. Or, for example, certain physical illnesses, or medications prescribed by family doctors for physical problems, can cause psychological symptoms, such as loss of libido. It is valuable to know about these and not assume that all psychological symptoms were caused by toilet-training or other childhood traumas (though these undoubtedly play a role, as well).

Aside from bringing awareness to mental health issues and lessening stigma, do you think therapist call-in shows, or television shows help people? In what ways?

Learning about mental health issues via the media can be very useful, in terms of de-stigmatizing these problems and making them easier to talk about with family and friends. The media can also be informative regarding warning signs, new treatments, and new insights. But, just like with treatment, the help that you get from psychiatrists or other therapists in the media is only as good as the therapist’s knowledge, experience and communication skills. And some therapists – on-microphone and off — do more harm than good by not really listening to the patient, but crafting their answers based upon their own agendas.

Do you still see patients despite your busy media schedule?

I see patients one day a week, and do expert witness work. However, the majority of the time, I devote to sharing my psychological insights through the media by writing books; creating audio and video programs; doing interviews on TV, radio and in print; hosting a radio show; and doing speaking engagements. This way, I can reach beyond my couch to help people all over the world.

Thank you so much for your generosity with your time, Dr. Carole.

About Dr. Carole Lieberman: Carole Lieberman, M.D., M.P.H. is a board certified psychiatrist who still believes that medication, although extremely important for some patients, is not a cure in itself. It is a band-aid that helps with symptoms, while the true healing is done through intensive psychotherapy. Dr. Lieberman was chief resident at New York University-Bellevue Hospital, and studied under Anna Freud in London. She is currently on the Clinical Faculty of UCLA’s Neuropsychiatric Institute and has a private practice in Beverly Hills. Dr. Lieberman is a best-selling author, talk show host, media commentator, speaker and expert witness. Her books include: Bad Boys: Why We Love Them, How to Live with Them and When to Leave Them; and Coping with Terrorism: Dreams Interrupted. Please visit her at her web site.  Enjoy media videos with Dr. Carole and her radio show on Voiceamerica.com.

Comments

This post currently has 5 comments/trackbacks.
You can read the comments or leave your own thoughts.

Trackbacks

From Psych Central's website:
Tweets that mention Beverly Hills Shrink-No Holds Barred Interview with Dr. Carole Lieberman | Therapy Soup -- Topsy.com (May 27, 2010)

    Last reviewed: 27 May 2010