Demystification Monday Psychiatrist vs Psychologist

Do you know the difference? If so, move along. Nothing to see here.

But I am often surprised at how often folks confuse these two professions. It happens ALL the time. Just one example: the writers of the television show Bones alternately call Dr. Lance Sweets a psychiatrist and a psychologist. Unfortunately, if you look at his fictional educational credentials, it turns out he's a psychologist. Ugh. His massively boundary-crossing, you-should-lose-your-license-and-you-make-my-skin-crawl unethical behavior makes me wish he was batting for the other team (apologies to any psychiatrists out there. I shouldn't be wishing him on you, either).

Ahem. Sorry. Moving on.

The basic educational distinctions between a psychiatrist and a psychologist:

Psychiatrists are physicians.  They go to medical school. Then they do a residency that includes specialized experience in psychiatry. They get a license to practice and a federal narcotics license and blammo: practicing psychiatrist (I'm pretty sure I made that sound a lot easier than it actually is).

Psychologists ... are more complicated. But they are not medical doctors.

You can become a "psychologist" by a lot of different routes, but it's almost always by getting a doctoral-level degree (unless you're a "school psychologist", which is often a masters-level qualification). There are several kinds of doctoral degrees, though (Ph.D., Psy.D., Ed.D.). And even within the Ph.D.s, there are a lot of different kinds--clinical psychology, counseling psychology, school psychology, etc.. But no matter which degree you get, you have to qualify to take the national exam and the state exam, and only after you pass those do you get to call yourself a psychologist (legally).

Click to see the basic requirements to become a psychologist. Here's a quick rundown on me:

• I have a bachelors degree in psychology (from Hope College ... it's in Holland, Michigan)
• I have a Ph.D. in clinical psychology from the University of Delaware. It took me 6 years to get that sucker. Anyway, it was an APA-accredited program. I took certain classes, completed a lot of supervised clinical practice, and did quite a lot of research. I did my 1-year, full-time, APA-accredited clinical psychology/pediatric psychology internship at The Children's Hospital of Philadelphia.
• I completed a 2-year postdoctoral fellowship at Brown University. I did more supervised, specialized practice and research during those years, and at the end of it, I took the state (RI) and national licensure exams.

So the most basic difference between psychiatrists and psychologist is MD vs. PhD (or other doctoral degree). But you know what? If you spend 8 years training to be a psychiatrist, you're going to think differently than if you spend that same 8 years training to be a psychologist. It's a different mindset, one I don't have the space to really explain here. Instead, I'll just offer:

The basic day-to-day distinction between psychiatrists and psychologists:

Psychiatrists evaluate, diagnose, and prescribe medication. They often work with another mental health professional who provides therapy.

Psychologists ... are more complicated. For the most part, we don't prescribe meds (there are 2 states that allow psychologists to prescribe if they get an extra masters degree in psychopharmacology). We do a lot of other things, though.

There's a general description here. Here's what I do:

• I perform psychological evaluations (which include IQ testing along with other psychological tests) and diagnose.
• I provide psychotherapy to children and families.
• I consult to schools and daycares (and anyone else who's wondering things like, "Why is that 4yo throwing chairs and threatening to kill people, and how do I get him to stop?!?!)
• I supervise and mentor other clinicians.
• I do program evaluation and research.
• I collaborate with other professionals regarding design of social service delivery systems and policies.
• Oh, and I write novels.

That is all.

Now ... does that clear anything up? Are you writing a story that includes a psychologist, psychiatrist, or some other type of therapist? Do you wonder how to portray the therapy process? If anybody has questions about the psychiatrist/psychologist distinction or anything else related to portrayal of these professionals in YA fiction, please do comment. I'll either answer them directly or cover them in future posts!

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At Least vs If Only

I spent January lost in a sea of WIP misery.

Yes. It happens to everyone, I know. My agent said something to me like, "you've only been at this writing thing for what, a year? Writer's block is 110% normal. Go read some books and don't worry about it."

[Here's an aside: Kathleen Ortiz is awesome]

But the whole thing terrified me, because ever since I started writing, I've been half-convinced the whole thing was a fluke. I'd gone through the first 35 years of my life without writing so much as a short story or a poem, and in the last year ... well. So perhaps you can understand why I'd believe my 2010 was some weird karmic joke. I've wondered if I'm like Charlie in Flowers for Algernon, destined for a brief period of illumination before losing all that light.

I'm still hashing all that out in the space between my ears.

But a week or so ago, I ditched my January WIP, even though I had written, in chaotic bits and pieces, at least half of it. And last weekend, I outlined another novel. And in the five days after that, I wrote the first 20,000 words.

Huzzah! Back in business.

Until Saturday, when I realized I'd written that first 65 pages from the wrong perspective.

All right, so I go on Twitter, and I mention this hilarious bit of stupidity. And two lovely Twitter-friends, Jennifer Walkup and Amparo Ortiz, reply and basically say the same thing--"AT LEAST you didn't [insert even more frustrating writerly experience here]"

Their sentiments, my friends, are called "downward counterfactuals".

And they were like a salve on my bruised writer's heart.

Funnily enough, I did some research on counterfactual thinking when I was an eager young undergrad. A counterfactual thought is a mental construction of an alternative to facts or events. It's a "what might have been." Human beings engage in this sort of thinking all the time. I do, too. Heh.

There are two major types of counterfactual thought--the upward and the downward.

The upward: "If only I had realized this book must be written in third person, I would have saved myself days and days of work."

The downward: "At least I didn't write a complete novel before realizing first person, though I loves it so very very much, is just not the right POV for this book."

The upward: "If only I had let this sit for a few days before plunging in, I might have figured this out sooner."

The downward: "At least I've put serious words to page for the first time in a few months, because that's a sign I am not regressing into my pre-writer existence."

Get it?

Both kinds of counterfactual thinking are useful.

If you are in need of MOOD REPAIR, downward counterfactuals should be the mental trick of the day. Thinking about how you've avoided a much-worse outcome will make you feel better! And who doesn't want to feel better (we'll save that for another post, shall we)?

If you are in need of a LIFE LESSON, upward counterfactuals are more your poison. After all, if we're all filled with relief because it could have been worse, we're not focusing on how we could do better. And who doesn't want do do better (you guessed it, another post is called for)?

All right, so which type of thinking fits your style? And in what kind of situation?

Do you comfort yourself with the downward counterfactuals? And if so, are you sure you're not protecting yourself a little too much?

Do you delve into possibilities for improvement with the upward counterfactuals? And if so, are you sure you're not beating yourself up a little too much?

Be sure to check out Lydia's Medical Monday post and Laura's Mental Health Monday post today as well!

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Demystification Monday Person vs Situation

All you writers of the dystopian genre might have particular interest in this one, but anyone who's putting a character in an extreme situation might want to pay attention as well.

Here is a relatively common misconception (when we're judging other people's behavior):

No matter the situation, your behavior depends entirely on what kind of person you are.

Well ... that's not such a crazy idea. Put 100 people in the same situation and they won't all act the same. For example, say a bunch of people are taken hostage. Some will cower and cry. Others will plot escape nonstop. A few will try to get friendly with the captors, even if it means tattling on the other hostages. Others will be utterly hostile and completely uncooperative. And some will do whatever it takes to get others out, even at the risk of their own lives. So what would you do? Do you know for sure?

How about this one: you're given a job. You're supposed to administer an electric shock to another person as part of a learning experiment. When the person makes a mistake, you must shock them. If they keep making mistakes, you must shock them more. If you hesitate, the boss will come in and stand over you, telling you that you have to do it. You're a good person, right? Would you push the shock button?

No?


Are you sure?

If you were observing this experiment from the outside, you'd probably be thinking, "What kind of sick, heartless, weak person could do something like that?"

If you were the person with that button beneath your sweaty fingers, you'd probably be thinking, "Why are they making me do this??" Zap.

This is what humans do. When we see someone do something, or when we see something happen to someone (especially something bad), we usually decide that the event occurred because of the person. His/her personality. Genetics. Soul. Whatever. Something inside of that person. You know, that person was lazy. Careless. Stupid. Evil. We go for the "dispositional" explanation rather than the "situational" one. This is so common that it has a name: Fundamental Attribution Error.

But situations have incredible power over us. You've probably heard of the Stanford Prison Experiment? Male college students were randomly assigned to play the roles of guard or prisoner for two weeks in a simulated prison. Except ... the experiment had to be ended after only 6 days.