I'm interested in hearing what exactly you mean by "lay psychoanalysis." Analysis performed by someone who isn't a mental health professional? Analysis performed by anyone who never received formal analytic training?

It's an interesting question, whether there is such a thing. On one hand, Freud himself was a lay analyst. On the other hand, there's probably a reasonably large contingent of (orthodox) analysts who would assert that it can't exist for structural reasons (the setting, the lack of payment, the nature of the relationship, etc.).

It's a thing. https://en.wikipedia.org/wiki/Lay_analysis

Who dismisses lay analysts in this sense? Not even analysts do anymore (as evidenced by the acceptance of psychologists into analytic programs). You said not involving a "professional." Freud was talking about physicians.

I just meant that, if you want some kind of psychoanalysis, you don't necessarily need to go the professional route. Medically trained psychoanalysts don't really have a clear advantage over lay analysts in terms of insight.

Oh sure. Agreed.

We need be careful not to conflate degrees with fields. Psychiatrists can and do engage in "doctoring," psychological testing, therapy, analysis, etc. Clinician psychologists can do all of the above except for prescribing meds. So saying "this is psychiatry and that is psychology" isn't really a thing except where medication is concerned. It wouldn't even be fair, in consideration of neuropsych, to say that psychologists categorically don't treat diseases as having root biological causes.

The notion of "biological root cause" is very controversial. In fact I would say that applying the notion of root cause to a distressed individual is part of the problem with the establishment—the situation is inherently complex, involving social context and psychodynamic aspects as well as biology.

If we had a solid reductionist biological theory of mental illness, we would still sometimes discover that the cause was strictly "outside" the patient's own physiology.

Psychologists certainly go along with the fashionable talk of "chemical imbalances", but unlike psychiatrists, they don't really claim any authority when they do it.

I've heard this claimed a lot, but I'm unsure what _is_ the current status quo in psychiatry. I say this as a layman who has undergone treatment from therapists and psychiatrists for years.

I'm not sure exactly what claim you are referring to. Maybe if you articulate it I can comment properly.

My general impression is that the only way to communicate how psychiatry is would be to write a very thick novel with characters who occupy many different positions in relation to the profession. Even then it would be hard to give an all-encompassing impression.

"chemical imbalance theory". I'm aware of people saying it's not accepted as science, but I'm sure what is the current accepted science.

It's a contested field. Try this article for example: https://www.scientificamerican.com/article/is-depression-jus...

Pretty much any competent psych*gist knows "chemical I'm balance" is a total crock of shit. But, it is reassuring to (most) patients to have their lived experience explained in terms of an understood model. Pharmacological interventions are basically running through a list of candidates drugs and asking the patient how they feel. (Limited third party observation in inpatient settings, but really everyone is too overworked). There is a bit of a flow chart to determine what classes of drugs to prioritize in the search, but it is not nearly as deterministic as e.g. antibiotics; stuff is used off label all the time. For example, I knew a person who lived bipolar 1 with extremely pronounced psychotic features. She finally ended up stable on... Amphetamine, plus an snri specifically contraindicated in anything involving mania or suicidal ideation. That's like, absolutely inconceivable. Yet it's worked for the past ten years or so.