From Skepticism to Competence: How American Psychiatrists Learn Psychotherapy
From Skepticism to Competence: How American Psychiatrists Learn Psychotherapy
by Mariana Craciun
University of Chicago Press, 2024 eISBN: 978-0-226-83390-3 | Paper: 978-0-226-83391-0 | Cloth: 978-0-226-83389-7 Library of Congress Classification RC459.5.U6C73 2024 Dewey Decimal Classification 616.89140076
ABOUT THIS BOOK | AUTHOR BIOGRAPHY | REVIEWS | TOC | REQUEST ACCESSIBLE FILE
ABOUT THIS BOOK
An examination of how novice psychiatrists come to understand the workings of the mind—and the nature of medical expertise—as they are trained in psychotherapy.
While many medical professionals can physically examine the body to identify and understand its troubles—a cardiologist can take a scan of the heart, an endocrinologist can measure hormone levels, an oncologist can locate a tumor—psychiatrists have a much harder time unlocking the inner workings of the brain or its metaphysical counterpart, the mind.
In From Skepticism to Competence, sociologist Mariana Craciun delves into the radical uncertainty of psychiatric work by following medical residents in the field as they learn about psychotherapeutic methods. Most are skeptical at the start. While they are well equipped to treat brain diseases through prescription drugs, they must set their expectations aside and learn how to navigate their patients’ minds. Their instructors, experienced psychotherapists, help the budding psychiatrists navigate this new professional terrain by revealing the inner workings of talk and behavioral interventions and stressing their utility in a world dominated by pharmaceutical treatments. In the process, the residents examine their own doctoring assumptions and develop new competencies in psychotherapy. Exploring the world of contemporary psychiatric training, Craciun illuminates novice physicians’ struggles to understand the nature and meaning of mental illness and, with it, their own growing medical expertise.
AUTHOR BIOGRAPHY
Mariana Craciun is assistant professor of sociology at Tulane University.
REVIEWS
"Empirically rich, theoretically sophisticated and highly readable, Craciun's book takes readers into the very interstices of psychotherapeutic training, and shows how residents grow from hard-nosed, biomedical skeptics into competent behavioral and psychodynamic therapists. The beauty of Craciun’s argument is that she analyzes skepticism not as an obstacle, but as a necessary step in a process of professional socialization that will conclude with competency and trust. In an age of mistrust, skepticism’s less disciplined cousin, the lessons that Craciun’s book teaches will resonate far beyond the field of psychotherapeutic training."
— Gil Eyal, Columbia University
"Mariana Craciun’s perceptive ethnography takes us inside psychiatric residency to explore the challenging journey of those learning how to treat mental illness. With vivid observations, Craciun brings the relational dimensions of their training to life, tracing the experience of residents as they watch, listen and practice psychotherapy within a community of instructors and colleagues. She not only offers fascinating details of how residents’ skepticism and doubt turn into expanded professional knowledge and identity, but we also see how psychoanalytic instructors work to broaden the legitimate approaches to psychiatry. As a result, From Skepticism to Competence is both a crucial contribution to our understanding of medical socialization and to the sociology of occupations and work."
— Beth A. Bechky, University of California, Davis
TABLE OF CONTENTS
Preface
1. Learning to Doctor in Psychiatry
2. Training at Shorewood
3. Doctoring Unmoored
4. Psychotherapy Instructors
5. Learning to Doctor in CBT
6. Learning to Doctor Psychodynamically
7. Competence and Resolution
8. From Skepticism to Competence: An Integrated Theory and Implications
Acknowledgments
Appendix: Facing Skepticism in the Field
Notes
References
Index
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