Donald A. Misch, M.D., PLLC
Life is not easy! All of us are subject to stressors—biological, psychological, familial, social, cultural, occupational, financial, spiritual—that interact with our genetics, innate temperament, and life experiences to make us who we are and how we think, feel, and behave. Yet, I also believe everyone has the capacity and opportunity to change, grow, and live a happier, more satisfying, and more productive life. My role as a psychiatrist is to help patients maximize their strengths, to overcome or lessen their challenges, and to flourish in their family relationships, academics, work, social circles, and as citizens of a community.
I believe that psychiatry should never be a “one size fits all” approach. Every individual is unique, and each treatment program should be individualized and tailored to the needs, concerns, and strengths of the individual. Similarly, I believe in a biopsychosocial approach that is responsive to the many factors that make each of us who we are. Biology and neurochemistry, genetics, family relationships and upbringing, important life experiences, culture and ethnicity, sexuality, religion and spirituality—all these and more are important considerations in mental health care.
Consistent with such an individualized approach to care, I try to employ a “big toolbox.” My goal is to use the therapeutic modalities that are best for my patient, not simply those with which I am most comfortable or those which I prefer or enjoy. Thus, my practice philosophy is eclectic; I do what I believe will be best for an individual patient. This may include psychotherapy of various schools (e.g., supportive therapy, psychodynamic therapy, cognitive-behavior therapy, mentalization-based treatment, and motivational interviewing), medication management, self-help groups, residential or inpatient treatment, and more.
Psychotherapy and/or Psychopharmacology
A word about psychotherapy versus psychopharmacology (medication management). Psychiatric medications can change lives for the better; and, when prescribed for the right person at the right time in the right way, they can alter a life course for the better. So I prescribe medications as is appropriate for my patient. At the same time, however, I am absolutely committed to the value of psychotherapy—talking about one’s concerns, struggles, and successes. Just as medications can treat certain problems that are relatively unresponsive to psychotherapy; so, too, can psychotherapy address difficulties in thinking, feeling, and behavior that are uniquely or primarily responsive to therapeutic interactions with a trained mental health professional. The combination of psychotherapy with medication management can be a powerful weapon in combating mental illness, life stressors, problematic relationships, and other issues for which a patient sees a psychiatrist.
Most important, whatever therapeutic school to which a mental health professional belongs or whatever therapeutic tools employed, critical is the development of a supportive, empathic, understanding, respectful, healing relationship with a patient as well as the mental health professionals’ belief in the individual and his/her capacity to change for the better. I cherish the opportunity to work with my patients and clients. It is truly a privilege for me to serve as a mental health professional, and I try to always respect and live up to the trust placed in me by those seeking mental health care.