Doctors and psychotherapists: who comes between them?

Some time ago my friend Jeff (not his real name) started seeing a therapist once a week, after finding himself struggling with anxiety and depression.

Things had got off to a positive start, Jeff said.

He felt as if he and his therapist were going to get along.

That seems to be one of the main keys to getting the most from therapy – if you and your counsellor have a good rapport, it’s an indication that the process could be rewarding.


The therapist began by getting Jeff to talk about his background, and his life at the moment, as well as some of the more memorable things that had brought him to where he was.

I suspect this is fairly normal, and seems a pretty sensible procedure.

Jeff had mentioned a physical health problem that had cropped up a few years back, but as he and I chatted, it occurred to us that there had been little or no talk about the extent to which he’d been taking care of himself.

No discussion about his diet (although Jeff’s therapist did ask him about smoking, drinking, and other types of pharmaceutical use – mainstream or ‘self prescribed’).

No conversation about the amount of exercise he took (or in Jeff’s case, didn’t).

No questions about his weight, or his aches and pains.

I don’t think this is in any sense a criticism of Jeff’s therapist – psychotherapy tends to do as its name suggests: it focuses on the psyche, leaving physiological matters to the family doctor who, in turn, may not ask too many questions about what’s going on in a patient’s mind (often because a physician simply doesn’t have the time – or even, on occasion, the skill – to delve into psychological matters).

Who, then, has responsibility for the meeting point of Jeff’s mind and body?

Just one person, we decided, and that’s Jeff himself.

Perhaps we need to learn from this?

At the end of the day, who’s going to take care of your body, and look after your mind?

You know, I think that mainly has to be your job.

8 thoughts on “Doctors and psychotherapists: who comes between them?

  1. Interesting observation and one that probably rings true for many people. However I would argue that the best healthcare professionals work with their patients to consider both the physical and mental effects of people regardless of their own specialisms.

    In the UK and elsewhere there is a lot of work being doing to stop separating physical and mental health in silos and instead really focus on holistic person centred care- i.e. what matters to the person. A person is the sum of their parts and not just collected individual parts that happen to be in the same package!

    1. I absolutely agree with the comment above, perhaps things are approached from a different perspective in the USA (and divided into categories? physical or mental?) but here in the UK we often refer to a holistic approach assessing both mind and body as a whole. My whole training is focused on looking at both physical and mental ill health as they go hand in hand and cannot/should not be separated. We have initiatives whereby the NHS/local authority will provide free gym memberships to service users as part of the recovery process, often a support worker will accompany someone who is wanting to improve their physical wellbeing but due to anxiety issues is unable to take that first step alone. This is collaborative working.

      In the UK we focus on assisting our patients/service users to reach a level of recovery they are happy with, we do not have access to an unlimited pot of gold (within the NHS), it is not perfect but we work with what we have. Whereas in the USA you are essentially purchasing this service as I understand it (psychotherapy etc), does that mean the patient then relies on the trustworthiness of the therapist to assist in reaching recovery? Who decides the timeframe or is it just an ongoing cycle? I’m very curious to know.

  2. At the end of the day only YOU can save yourself. It’s a tough world. And no one is going pull your boot straps up for you. That can all try. But in the end it’s YOU that must do it. You’ve heard of the phrase you can lead a horse to water….

  3. It took me 85 years and a long list of physicians (who seemed to leave the area one after another for greener pastures ) for me to learn that the person who did the most for my health of body and mind was ME! I continue to see physicials regularly for check-ups but I am the one who takes the most interest in keeping myself healthy and strong.

  4. How we are about ourselves including exercise and eating is very linked to our sense of self and how we grew as a child, what our environment was and is and our beliefs about ourselves and these issues. The body remembers everything so it is central to work in psychotherapy and empowering our path to recovery in my experience as a person, client and therapist.

  5. “I’m trying to free your mind Neo, but I can only show you the door. You’re the one that has to walk through it”.
    Pop culture quote from The Matrix I know, but this was always how I felt my therapy should be (and is).

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