From Skepticism to Competence: How American Psychiatrists Learn Psychotherapy

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.

Mariana Craciun is assistant professor of sociology at Tulane University.