Living in a Medical World: The Impact of Professional Training, and Medical Culture on Cognition

• In Event: 3483 - Open Refereed Roundtable Session
  In Refereed Roundtable 100min: Table 03. The Medical Profession: Training, Culture, and Moral Authority

Abstract

In this paper, I draw on data from 30 interviews with psychologists and psychiatrists to offer insight into the impact of professional socialization, institutional constraints, and professional culture on cognition. I explore practitioners’ divergent experiences of combined treatments, which combine talk therapy and prescription medicine. While combined treatments are accepted as the appropriate approach for patients with significant symptoms, their use leads to different outcomes for different kinds of practitioners. For the practitioners I dub Psychodynamic Psychologists (PhD), who are trained in talk therapy, but cannot prescribe medications, the process of referring patients to psychiatrists for medications requires to slow, measured, careful thought and action. On the other hand, the practitioners I refer to as Biodynamic Psychiatrists (MDs), who are trained in both talk therapy and the medical model (and can prescribe medication), achieve the same goal with little to no conflict, relatively routinely. Biodynamic Psychiatrists can easily use combined treatments because their treatment toolkit allows them to control all aspects of the treatment, and because of their medical training they are more wedded to the medical model than the Psychodynamic Psychologists. Though Psychodynamic and Biodynamic practitioners agree that combined treatments are ideal for highly symptomatic patients, achieving that goal requires different cognitive processes for the two groups. This case allows for insight into the conditions under which cognition is more or less automatic or deliberative.

Author

• Dena T. Smith, University of Maryland-Baltimore County