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March 14, 2001

Training in Psychiatric Consultation—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;285(10):1290. doi:10.1001/jama.285.10.1290

In Reply: My criticism of Dr Robinson's book reflects my view that it represents exactly what can be wrong in psychiatry and unfortunately tends to pervade much of psychiatric teaching. It presents the approach to the patient in a shorthand, stereotyped, technical way that misses the essence of what psychiatry at its best is all about. Psychiatry should be as much an education about human behavior as a training in procedural skills. I have had wide experience teaching medical students and house staff in psychiatry, as well as medicine, and what fascinates them still are the nuances of human behavior. Admittedly it takes years of experience to develop a personal style and a personal view. Yet, it is of critical importance that what Robinson calls "the neophyte consultant," or the neophyte psychiatrist for that matter, know that there is something in the interaction with a patient that is not only a source of fascination, but the only real vehicle of establishing contact with a patient. This is the task of the physician and does not contradict the need for basic knowledge. No attention is paid to this in Sigmundoscopy. For a psychiatrist to ignore this feature is to risk sterility for the entire enterprise.