Why I Practice Integrative Psychiatry

My Parallel Education

Reason #1: I have more to offer my patients than just medications

Alongside my medical and scientific training, I completed what I like to call my parallel education in yoga therapy. This was a 3-year process that built on 10 years of experience as a yoga student, and was concurrent with my postdoctoral fellowship in neurobiology, while I was living in Switzerland.  What is most important is that this training, the time I spent as a student of yoga therapy practices, and my experience with teaching yoga and meditation to my colleagues, friends, and others, all occurred prior to my return to clinical work in psychiatry.  This allowed me to formulate a clinical approach to psychiatry that always included an integrative perspective on mental health treatment. It has also given me extra tools, beyond medications, that I can offer to my patients, as they chart their unique paths towards whole person well-being.

Things are Changing

Reason #2: The Evidence Base for Integrative Psychiatry is Growing

More and more evidence is accumulating demonstrating the efficacy of non-medication augmentation strategies for mental health.  What this means is that more researchers have become interested in studying the effects of combining nutritional and herbal supplements, life-style changes (such as diet, exercise, and other changes in habits), and mindfulness-based interventions with psychotropic medications for treatment of mental health diagnoses.  Since most academic clinicians, and any clinician keeping up with the evidence base, rely on researchers to conduct the studies that inform their treatment strategies, this is a really exciting time to be practicing integrative psychiatry, because we know more about which strategies are most likely to work.  There have also been innovations in the field of neuromodulation, which is just a fancy term for technology that involves activation (or inactivation) of regions of the brain that contribute to mental health symptoms.  These are newer and very effective non-medication treatments with an expanding number of applications across different age groups.  The evidence base for non-medication augmentation strategies continues to grow, making integrative medicine approaches more acceptable to the medical community, and more useful to patients.

Autonomy, Choice and Becoming Unnecessary

Reason #3: Integrative psychiatry relies on patient self-empowerment and autonomy

I don’t believe entering into a treatment relationship with a psychiatrist is meant to be a life-long commitment.  In fact, I believe our goal as physicians should be to become unnecessary. There is also something troubling to me about any treatment relationship that builds a feeling of dependency in a patient, rather than nurturing self-empowerment and autonomy. Integrative psychiatry places well-being in the hands of patients by offering medication augmentation strategies that are dependent on the patients daily choices, rather than relying on the psychiatrists prescribing privileges alone.  The role of the psychiatrist in integrative psychiatry is to provide knowledge, and to coach or guide, as it involves teaching, motivating, troubleshooting, and thoughtfully passing the responsibility for improvement from the psychiatrist to the patient, over time.