Beyond the Pills: When Psychiatry Falls Short
You have to leave (or log on?) in 5 minutes, and you’re dreading it.
Don’t be late, because the office will cancel your appointment, charge a fee, and book you for the next available…. in 10 weeks.
You can’t put your finger on it exactly, but you know that these psychiatry appointments just feel…off.
Like, you’re pouring our your heart and soul, and getting back a couple of “hms” and a refill on your prescription.
Maybe you even feel like you were scolded for having some really hard days, messing up a med schedule, or asking about the side effects that are making you sick.
You might feel a mix of hope and unease, but beneath it all, the question remains: will this actually help, or will it just make things worse?
For many, a visit to a psychiatrist can feel less like a step toward healing and more like a rushed medical transaction.
Capitalism. Tension. Cortisol.
We’ve been told that these doctors are the key to mental wellness, but for many of us, this experience can feel superficial and disempowering.
Of course, sometimes psychotropic medications are absolutely critical and 100% lifesaving.
This isn’t what we’re talking about here, and I’m not criticizing psychiatrists as people. They are educated, trained, and pushed into a broken system.
I want you to know it’s not your fault that your psychiatric treatment isn’t working. And if you don’t feel comfortable with your psychiatrist, this one’s for you.
We need to understand the system and the approach- the medical model, to release the burden of guilt and shame.
This post will explore the common complaints against psychiatric care and why it can feel unhelpful and even invalidating for people like you who are looking for real, lasting change.
The 15-Minute Appointment and the Checklist Approach
Many of my clients tell me that their psychiatrist appointments feel incredibly rushed.
The average psychiatrist appointment lasts about 15, 20 if you’re lucky, minutes of 1:1 facetime with your doc.
In this short window, the entire exchange often follows a predictable script.
You are asked a series of quick questions about your symptoms.
You give short responses, often feeling like there's no time to explain the full story, or
You try to explain and describe your experience, only to be cut off or interrupted and talked at.
A label is assigned based on the checklist of symptoms from the Diagnostic and Statistical Manual of Mental Disorders (DSM).
The primary solution offered is medication.
You walk in hoping for a deep, compassionate conversation about your life and leave feeling like you’re just a set of symptoms to be managed.
Your unique, complex human story gets reduced to a cluster of symptoms that fit a pre-defined label.
This can leave us feeling like we’re being forced into a box. You may have wanted to share about the stress of your job, the strain in your family, or a difficult memory from childhood, but there simply isn't time.
The unsaid parts of your story remain unaddressed, and the core of your pain is never truly seen.
This is a direct result of a system built on the medical model.
This model views mental health struggles as diseases that can be diagnosed and treated with medication. It’s effective for many medical conditions, but it can be a poor fit for the complex, nuanced reality of human experience and trauma.
The Medical Model vs. a Trauma-Informed Approach
To understand why your psychiatrist appointment feels so frustrating, it's helpful to see the difference between the medical model and a trauma-informed approach.
The Medical Model
Focus: Symptoms and diagnosis. The primary question is "What disease does this person have?"
Cause: Assumes a biological or chemical imbalance in the brain.
Treatment: Primarily medication to correct the perceived imbalance.
Power Dynamic: The psychiatrist is the expert who holds the knowledge and prescribes the fix. The patient is a passive recipient.
A Trauma-Informed Approach
Focus: The whole person and their life story. The primary question is "What happened to you?"
Cause: Acknowledges that symptoms are often intelligent, protective responses to overwhelming or traumatic life experiences.
Treatment: A blend of talk therapy, body-based work, and sometimes medication. The goal is healing the root cause, not just managing symptoms.
Power Dynamic: The client is the expert on their own experience. The therapist is a compassionate guide and partner on the healing journey.
When a psychiatrist focuses only on the symptom and not the story behind it, they can miss the point entirely.
The medication might numb the feeling, but it doesn't address the root cause- the underlying trauma or life event that led to the symptom in the first place.
This is like trying to put a bandage on a broken bone.
A pill can help with the pain, but it doesn't address the underlying break.
We’re left with a quick-fix solution for a deep, complex experince. This can feel deeply invalidating.
The Matrix of Mental and Physical Health
Our mental health struggles are not separate from your physical health. They’re really deeply intertwined.
For years, Western medicine has treated the mind and body as separate entities. But a trauma-informed perspective sees them as a dynamic, connected system.
Think about the physical signs of anxiety or stress that you experience. Maybe you have digestive issues like IBS, chronic headaches, muscle tension in your jaw and shoulders, or a constant feeling of being "on edge."
These aren't random physical problems. They are direct manifestations of a dysregulated nervous system.
Your autonomic nervous system has two main parts. The sympathetic nervous system (SNS) is your body’s gas pedal- it handles the "fight or flight" response. The parasympathetic nervous system (PNS) is your body’s brake- it handles "rest and digest."
When we experience trauma or chronic stress, SNS can get stuck in the "on" position. It’s like the gas pedal is pressed down and staying there.
This constant state of high alert floods your body with stress hormones like cortisol and adrenaline.
Over time, this can lead to chronic inflammation, a weakened immune system, and a host of physical ailments.
Mentally, this chronic nervous system activation shows up as anxiety, irritability, brain fog, and exhaustion.
A medical model approach often treats these as separate problems.
A psychiatrist gives you a pill for anxiety. Your primary care doctor gives you a pill for your headaches. But they are often two sides of the same coin.
A trauma-informed approach sees the connection. It addresses the nervous system dysregulation at the root of both the mental and physical symptoms.
A Look at Psychiatric Training
To understand this disconnect, it's helpful to look at how psychiatrists are trained.
Their training is rigorous and medically focused.
Medical School: They spend four years learning general medicine. They study anatomy, physiology, chemistry, and disease from a biological perspective.
Psychiatric Residency: They complete a four-year residency focused on diagnosing and treating mental illness, primarily with psychopharmacology (medication management). They learn which pills to prescribe for which symptoms.
This training makes them experts in the biology of the brain and the effects of medication.
This is absolutely necessary for conditions that are primarily biological in nature.
However, their training often misses a huge chunk of what is needed for trauma-informed care.
Limited Trauma Training:
While they get some exposure to trauma, it is not the central focus of their education. The deep study of attachment theory, somatic therapies, and how trauma is stored in the body is often not part of their core curriculum.
Short Appointments:
The standard appointment structure is built for medication management, not for the long, slow, and often messy work of trauma healing. There simply isn't time in a 15-minute slot to explore the nuances of your life history.
Lack of Psychotherapeutic Practice:
Many psychiatrists no longer practice talk therapy themselves. They are medication specialists who work in tandem with a therapist. While this can be a great system, it can also lead to a feeling of being passed from one professional to another without anyone truly understanding the whole picture.
Lack of Personal Development and Insight:
Many psychiatrist feel like therapy, psychotherapy, and anything other than qualitative studies using chemical devices is “woo woo.” They may never have engaged in personal exploration via psychotherapy or other healing experiences. Sometimes our psychiatrist doesn’t actively explore their biases, motivations, protectors, and reactions.
This is why your psychiatrist may talk over you or seem to lack empathy.
It's not because they are a bad person.
It's because their training has conditioned them to look for symptoms and justify their proposed medical solution.
The system they operate in prioritizes efficiency and diagnosis over deep listening and human connection.
And in many medical situations, this efficiency and solution-focus is exactly what is necessary for treating a client.
The Role of Attachment Theory
A critical piece that is often overlooked in the medical model is the role of attachment theory.
Our earliest relationships with caregivers shape how our nervous system learns to seek safety and connection.
If your caregivers were inconsistent or emotionally unavailable, you might have developed an anxious attachment style. You learned to people-please and put others' needs first to earn love and attention. This can show up as constant anxiety and overwhelm in adulthood.
If your caregivers were dismissive or avoided emotional closeness, you might have developed an avoidant attachment style. You learned to be fiercely independent and suppress your needs. This can manifest as a feeling of numbness or emotional detachment.
If your caregivers were unpredictable or a source of fear, you might have developed a disorganized attachment style. You learned that the person who is supposed to keep you safe is also a threat. This can create a constant inner conflict that looks like anxiety or depression.
These deeply ingrained patterns, which were brilliant survival strategies in the past, are often what drive the symptoms that a psychiatrist diagnoses.
But without understanding the root in attachment and trauma, the medication is just a temporary fix.
It’s treating the symptom without healing the relational wound.
The Loss of Agency: When the Power is Taken Away
One of the most damaging aspects of this medical model is the way it can take away your agency.
In this dynamic, the psychiatrist is the expert, and you are the patient.
The doctor holds the authority to diagnose and treat, while you are expected to be a passive recipient of their knowledge and prescriptions.
This power imbalance can be incredibly disempowering for successful, hardworking people who are used to being in control of their lives.
The focus is on what’s wrong with you, a chemical imbalance, a dysfunctional brain, rather than your innate capacity for healing and resilience.
It sends a subtle message that your body and mind are broken and that you need an external authority to fix them.
You may begin to question your own intuition and gut feelings about what you need.
The healing journey becomes about conforming to a diagnosis, not about reclaiming your wholeness and inner wisdom. This can be a form of retraumatization.
When we are not heard, validated, or respected, it can echo past experiences of feeling powerless.
Why "Just Say No" Isn't Enough
If you're caught in this exhausting cycle, you've probably heard well-meaning advice like, "You need better boundaries," or "Just relax and breathe."
While this advice isn't wrong in theory, it often doesn't help.
Your struggle isn't a lack of willpower.
The real issue is that these patterns are built into your nervous system at a subconscious, physical level. Your body learned these responses- the constant alertness, the urge to please- as vital for survival.
This happened during a time when your safety or emotional well-being was truly threatened.
Telling yourself to "just relax" when your nervous system is screaming "danger!" is like telling a smoke detector to stop beeping.
Your body is still reacting to past threats. It's a deep, physical issue, not just a "mind problem."
The need to people-please is a fawn response. It's an automatic effort to appease a perceived threat to avoid harm.
The feeling of being stuck or apathetic can be a freeze response, a brilliant way your system conserved energy when fight or flight was not possible.
These are clearly not conscious choices.
They are wired responses. To truly heal, we must address the root cause and retrain your nervous system.
Making Your Appointment Work for You
Since the psychiatrist's office often operates on a rushed, symptom-focused clock, the responsibility of communication falls on you, the client.
You can shift the power dynamic and ensure your crucial needs are met, even in a 15-minute slot.
1. Before the Appointment: Preparation and Grounding
Your goal here is to enter the appointment as regulated and prepared as possible to minimize stress and maximize the limited time.
Ground Your Nervous System: Address the dread and stress response before you log on. Before logging on, place your feet flat on the floor or hold an ice cube for 60 seconds. Say, "I am safe right now. This is a task, not a threat."
Prepare a "Top 3" List: Ensure you cover the most urgent items first before time runs out. Write down your list and start the meeting by saying: "I know our time is tight. I made a list of the three most important things I need to cover today."
Track Precise Data: Give the doctor measurable data they can quickly process, making it harder to dismiss your concerns. Instead of "I feel sad," track frequency: "My depression score is a 7 out of 10. I had intrusive thoughts 4 days last week, up from 2 the week before."
Clarify Medication Needs: Avoid feeling scolded for missing doses or having side effects. If you missed a dose, state it simply: "I missed my Tuesday dose. Is there anything specific I should watch out for now?"
2. During the Appointment: Communicating as a Collaborator
You have a right to ask questions until you feel informed and respected.
Use these scripts to shift the power dynamic and facilitate a partnership.
If you need more detail on a plan: "Before we decide, what are the expected outcomes of this change and what are the three most important red flags I should look out for?"
If you feel cut off or rushed: "I appreciate the time, but I need 30 more seconds to explain this one thing because it directly relates to my medication side effects."
If you feel scolded or judged: "I feel a bit judged right now. Can we talk about what you need to know about my schedule so we can work together to make the medication plan safer for me?"
If you disagree with the prescription: "I hear you about this medication, but I'm feeling uneasy. Can we discuss the pros and cons of trying medication A versus medication B instead?"
3. After the Appointment: Debrief and Regulation
The period immediately following a high-tension appointment is critical.
Help your nervous system return to a rested state.
Acknowledge the Cortisol: Don’t dismiss the feeling of stress. Recognize that your body went into a stress response. Tell yourself, "That was stressful, and it's over now."
Physical Release: Stand up and gently shake out your hands and arms. Splash cool water on your face. This signals to your nervous system that the danger is gone and you can shift out of high alert.
Journal for Discharge: Immediately jot down a few bullet points about what felt hard and what felt useful. This externalizes the negative feelings so they don't loop in your mind.
Consult Your Therapist: Bring your Top 3 List and your Debrief Notes to your next therapy session. Processing the power dynamics and emotional impact of the appointment with your therapist is key to preventing re-traumatization and integrating the experience.
My Approach to Healing: A Different Path
As a grief and trauma therapist, my approach to healing is fundamentally different from a traditional psychiatric model.
I don't see your struggles as a disease to be cured.
Instead, I see them as valid, sometimes brilliant, responses to your life experiences.
I listen to your story. I don’t come to our sessions with a checklist or a pre-determined diagnosis. I come with deep curiosity and a commitment to hearing your entire story.
I help you reclaim agency. My role isn't to fix you. It's to help you reclaim your agency and connect with your own inner wisdom. The power is within you.
We look beyond medication. While medication can be a helpful tool, it's only one piece of the puzzle. We will explore therapy that addresses the root causes of your symptoms, such as trauma-informed therapy or somatic work.
I believe that your symptoms are messages from your body and your history.
Our work is about helping you understand those messages and guiding you back to a place of inner peace and security.
Finding Your Way to Ease: A Trauma-Informed Path to Balance
Breaking free from the chains of chronic overwhelm is an incredibly brave journey.
It takes deep self-compassion and a clear focus on getting your nervous system back in balance. It means gently letting go of old survival strategies that no longer serve you.
This path is absolutely possible, and you don't have to walk it alone.
Trauma-informed therapy offers an understanding space and special tools to guide you through this life-changing process. It's not about "fixing" you.
It's about helping you return to your natural wholeness and your inborn ability to find ease. These therapies work with both your mind and your body.
We know that real healing means dealing with the experiences stored in your nervous system.
Here’s how a trauma-informed approach can help you find your true self and peace.
Creating a Non-Judgemental Space: This is the foundation of our work. For many survivors, therapy is the first place where their constant worry and exhaustion are truly heard and accepted without judgment. This basic safety helps your nervous system start to settle.
Connecting with Your Inner World with Internal Family Systems (IFS): The "parts" of you that feel pushed to please and are constantly overwhelmed often grew as clever protectors. IFS therapy offers a kind way to understand these inner "parts." By getting to know them and understanding their good intentions, your core "Self" can step up as the leader of your inner system.
Calming Your Nervous System with Somatic Therapy: This powerful therapy directly deals with the tension and imbalance stored in your body. Somatic exercises help you gently release the "stuck" survival energy from past traumas. This releases the extra energy your body has been holding. It helps you feel more calm, safe, and grounded within yourself.
Building Self-Compassion and Boundaries: A key part of this journey is practicing self-compassion. Therapy helps you replace harsh self-criticism with kindness and understanding. You learn to recognize your own worth and set healthy, respectful boundaries that protect your energy, time, and emotional well-being.
When Medication is the Solution (And a Key Part of the Journey)
It’s important to state that the experiences discussed in this post do not apply to everyone, and my frustration with the medical model isn’t criticism of the lifesaving role medication plays for many people.
I’m not an anti-vaxxer and anti-doctor: I believe in science.
For lots of people, psychotropic medications are absolutely essential and are the key to stability and a higher quality of life.
Medication is often the intervention that creates the safety and capacity needed to begin the deeper work of trauma therapy.
Medication as a Foundation for Healing
Think of medication not as a "quick fix" but as a necessary foundation- a life raft that keeps you afloat until you have the energy and regulation to get to shore.
For Acute Symptoms: In cases of severe depression, debilitating anxiety, or psychosis, medication can be a critical tool for managing acute symptoms, reducing the constant noise of the nervous system, and restoring fundamental functioning (like sleep and appetite).
Creating Capacity: When your system is in chronic "fight or flight," you simply do not have the emotional or cognitive bandwidth to engage in deep trauma work. Medication can dial down the intensity of the stress response, creating a window of tolerance where you can safely process emotions and memories in therapy.
Validating Relief: If you have found a medication like Prozac, Zoloft, or Wellbutrin to be immensely helpful, that relief is real and valid. Your body and mind responded positively to the support. It means you were able to access a stability that was previously impossible, and that is a victory.
My critique is of a system that offers medication as the only available solution, due to money or time or some other bullshit.
A trauma-informed approach recognizes that the best path forward is often a collaborative one where medication management is paired with the deep relational and nervous system work done in therapy.
The goal is to use every available tool to help you feel grounded and secure.
I'm Open to Dialogue
I understand that this post may be a strong statement for some. If you are a psychiatrist or a medical professional and feel that any information here is inaccurate, or if you’d like to share your perspective on this topic, I encourage you to reach out to me directly.
I am always open to a professional and respectful discussion about the future of mental healthcare. My goal is simply to help my clients feel seen and understood, and open communication is the best way to do that.
Interested In Therapy?
If this post resonates with you, know that you are not alone. Your experience is valid. You deserve a healing relationship where you feel seen, heard, and respected.
If you are ready to explore a personalized, thoughtful path to well-being, I’d be honored to work with you.
Schedule a free, 15 minute phone call to talk about therapy and explore your options.
