In China, doctors who treat psychosomatic-related diseases or disorders are called psychologists, and there was a popular reading book called “Psychologist” many years ago, not a professional journal, but it has played a positive role in promoting psychological knowledge and mental health. However, in contemporary China, where the popularity of psychology is increasing and the demand for psychotherapy is growing, there is still a lot of confusion about the knowledge and choice of psychologists. People are often confused about how to choose the right psychologist for them, where to find a psychologist, what are the characteristics of each of the various professionals who can provide psychological counseling and treatment services, and so on. In my clinical practice, I am often asked such questions by my patients, so I will clarify them for you below. First of all, we should understand that in Europe and the United States, where the discipline of psychology originated earlier and is more popular, there is no such term as a psychologist. Psychologists is a unique term in China, and people categorize professionals engaged in psychological counseling and treatment as doctors. In fact, this phenomenon is related to the history and current situation of traditional medicine in China. As we know, Chinese medicine has existed for more than 2000 years and has not been completely replaced by modern medicine, but is still stubbornly surviving and occupying a place in the hearts of the common people. However, Chinese psychology has never been separated from medicine or philosophy to become an independent discipline, and psychological ideas are submerged in the theory and practice of Chinese medicine, unknown. Therefore, doctors who treat psychosomatic diseases are naturally called psychologists. But in fact, psychological theories are very different from medical theories, and psychologists think and work very differently from general physicians. In this sense, the term psychiatrist is a bit of a misnomer, as will be discussed in detail later. Let’s start with the West. The term psychologist is translated into English as psychological doctor, but can be misunderstood as a doctor of psychology rather than a psychologist who practices clinical psychotherapy. There are several professional titles related to psychiatrists at present: one is psychiatrist, a doctor with a clinical medical background who treats psychiatric disorders, and a medical surgeon or dermatologist is a system of clinical specialists who generally work in psychiatric hospitals, or in psychiatric or psychological departments of general practitioners, with prescriptive authority and systematic physician education. For example, Freud, the originator of psychotherapy, was a neuropsychiatrist, the originator of psychoanalysis, and the originator of the concepts of “Libido” and “subconscious”. He is also the originator of psychoanalysis, the great man who introduced the concepts of “Libido” and “subconscious”, and is known as one of the three most influential Jews in the world, together with Marx and Einstein. His psychoanalytic theory has become the source of all contemporary psychotherapies, such as cognitive-behavioral therapy, family therapy, and humanistic therapy, all of which are derived from and derived from psychoanalytic therapy. For example, Beck, the American psychiatrist who founded cognitive-behavioral therapy, is still alive, and cognitive-behavioral therapy has become the most evidence-based psychotherapeutic approach. Also, there are famous psychoanalysts such as Jung and Kohut, all of whom are psychiatrists. However, to be clear, not all psychiatrists are willing or able to do psychotherapy, especially in this country, where more than 95% of psychiatrists are biologically oriented psychiatrists. There are many reasons for this, focusing on three: first, in the wards and outpatient clinics of psychiatric hospitals, general psychiatrists are very busy with their daily work and simply do not have time to do psychotherapy; second, within the training system of domestic psychiatrists there is no training content for psychotherapy at all, and if they do not go to additional study of psychology, they simply will not do psychotherapy; third, psychotherapy is not popular in China, and the fees are extremely low, so general Psychiatrists are not willing to do psychotherapy. As a result, many patients who request inpatient treatment in psychiatric hospitals in the hope of receiving professional psychotherapy are often disappointed to find that psychotherapy services are out of reach in addition to medication. Of course, psychiatric specialty hospitals nowadays arrange a large number of rehabilitation programs, such as singing, dancing, work recreation therapy, etc., which in fact are not psychotherapy in the sense of obvious treatment, just as Chinese medicine health care is not treatment at all. In short, it is estimated that only 5% of psychiatrists really understand psychotherapy and put it into practice, and can be called psychologically oriented psychiatrists. Compared with psychiatrists with a biological orientation, they are “rare” in that they have extensive medical experience in the treatment of various psychiatric disorders, can make a good differential diagnosis, have prescriptive authority, and have systematic knowledge of psychological theory and profound experience in psychotherapy, for patients who need both medication and psychotherapy. They have a unique academic advantage for complex patients who need both pharmacological and psychological treatment. In addition, their “rarity” lies in the fact that they are people who really love the psychiatric profession and have great empathy for patients with psychiatric disorders, and they are willing to look at patients with psychiatric disorders from the perspective of psychology and human nature, instead of looking at them from the biological perspective alone and ignoring their existence. This is because psychiatric disorders are not strictly diseases, but rather a disorder that is closely related to social and psychological factors. These patients are more likely to have a sense of shame, to have a thinner skin, to be marginalized by society, and to be less understood by people around them, so the doctor treating these disorders has a very high requirement, which requires a sharp and soft compassionate heart, an open philosophical vision, a calm professional posture, a warm humanistic feeling, and a comprehensive and systematic set of professional abilities, all at the same time. One of them is indispensable. Another type of counseling profession is the counselor, a social profession certified by the Ministry of Human Resources, which is not affiliated with a medical or educational institution, but is a kind of freelancer, often working in a private counseling office. Some of them come from psychology classes and later get counselors, but most of them are from other industries, often “halfway”. On the one hand, they are a group of people who are very sensitive to their profession, and on the other hand, they are often aware of their own psychological problems, and after deep thinking and analysis, they have deep experience in the process of wanting to solve or are solving their own psychological problems. Therefore, the counseling services provided by counselors are more pure, facing clients with milder conditions, generally better social functioning, and more inclined to address the counseling goals of personal growth and improving the quality of life. The advantage of counselors is that they only provide services in a more purely psychological sense, which do not involve medication and do not put the patient under the pressure of feeling sick and stigmatized. The disadvantage is that dealing with complex cases can be somewhat overwhelming, especially for patients who require medication, and often require the involvement and assistance of a psychiatrist to proceed better. It should be noted that counselors with a primarily psychoanalytic orientation often call themselves psychoanalysts, counselors with a cognitive-behavioral therapy orientation call themselves cognitive therapists, counselors with a family therapy orientation call themselves family therapists, and so on and so forth, but these are just variations on the name and are essentially the same thing. The third type of profession engaged in psychological counseling is psychotherapist, a group of medical people with the title of psychological technician in the hospital system, who are usually graduates of medical specialties or psychology, not qualified to practice medicine, but can assist psychiatrists in providing psychotherapy services, a group of psychotherapists developed in the last 10 years. They appear in wards and will lead patients in implementing group therapy, and in recent years have also begun to participate in outpatient individual psychotherapy services, but require a medical prescription from a psychiatrist before they can perform psychotherapy, and do not have independent diagnostic and treatment authority, nor prescriptive authority. However, the problem is that psychotherapists in the hospital system have a low academic status and charge low fees, are not recognized by patients, have a low sense of achievement, and need to be supported institutionally by the hospital. There is no shortage of very experienced psychotherapists in this section, and patients can choose according to their actual situation. The fourth type of personnel engaged in psychological counseling are psychology teachers in universities or research institutes, such as the School of Psychology of Peking University, the School of Psychology of Beijing Normal University, the Institute of Psychology of the Chinese Academy of Sciences and other institutions of higher learning. They come from psychology classes and have a deep background in psychology theory, but not all teachers specializing in psychology can engage in psychological counseling and therapy. Because psychology is a large specialty and counseling and therapy is a small specialty area under the large specialty of psychology, only a small number of college and university teachers are engaged in counseling and therapy. They have contributed a lot to the standardization and academicization of counseling and therapy. However, their counseling and therapy practice is often limited to the psychological problems of college students and does not involve parochial psychiatric disorders. They need the support of psychiatrists to carry out counseling and treatment well. These are the four categories of people who can provide psychological counseling and treatment to patients. For the sake of understanding, we seem to distinguish their differences in terms of the type of disorders that patients suffer from and can refer to in order to select them. The first category is major psychotic disorders, such as schizophrenia, bipolar disorder, major depressive disorder, and personality disorders with co-morbidities of the above disorders, which generally require medication, on the basis of which they receive psychotherapy. The order cannot be reversed, and psychotherapy must be administered more safely by a biologically oriented psychiatrist. However, in practice, the likelihood of receiving psychotherapy for these types of mental disorders is very low in clinical practice, and implementation is difficult. Therefore, it is more appropriate for psychologically oriented psychiatrists to implement psychotherapy in China, because they provide more integrated treatment and do not cause artificial fragmentation of medication and psychotherapy, so that patients get more benefits. The second category is at the level of personality disorders and is divided into category A (paranoid, schizoid, and schizotypal personality disorders), category B (antisocial, borderline, performance, and narcissistic personality disorders), and category C (obsessive-compulsive, avoidant, and dependent personality disorders). This group is unique and varies greatly. Some are successful, some are poor, some are courteous, some are rude, some are condescending, and some are condescending. This group is generally less likely to come to therapy, especially if they are socially functioning, often when they are experiencing stressful events co-morbid anxiety or depression. Those with a penchant for psychotherapy tend to have Type B and Type C personality disorders, especially the Type B population. They are more demanding and challenging for psychotherapists. They are ineffective with medication, which only temporarily alleviates symptoms, and long-term use of medication can create many problems with possible co-occurring substance or alcohol abuse. These patients can be treated by the four types of personnel mentioned above, but need to receive psychological supervision and psychiatrists to help guide them to better implement psychotherapy. The course of treatment is usually long and may take as long as several years. The third category is neurotic level disorders such as mild to moderate depressive disorders, anxiety disorders, obsessive-compulsive disorders, conversion disorders, eating disorders, and simple personality disorders without co-morbidities, etc. Depending on the severity of the disorder, they may or may not receive medication, so psychotherapy services can be provided to all of the above four categories. The possibility of receiving only psychotherapy depends not only on the severity of symptoms, but also on whether the patients themselves have the conditions for psychotherapy, such as economic status, geographical limitations, time, energy, self-functioning, reflective ability, and other factors. Because medication is in fact more economical, simple and direct compared with psychotherapy, it still dominates in clinical practice. The fourth category is general psychological problems, such as marital relationships, parent-child relationships, adjustment disorders, intimacy, test anxiety, and personal growth. Patients with these types of problems tend to function well socially, suffer less, and have relatively simple problems, and can receive psychotherapy services from the above four categories. However, it is important to note that these types of problems are often only the surface of a person’s problems, and there may be deep-seated psychological problems, such as personality disorder issues. This requires more specialized and sustained psychotherapy services. In addition, I often receive consultations from patients’ families, who are more concerned about the following types of issues: The first issue is trying to determine whether their family member has a mental illness, and what to do. First of all, this question involves the issue of discourse. It is ethical to judge someone’s illness without his or her authorization, which means the controversy of “being mentally ill”. Because everyone lives in his or her own subjective world, it is inevitable that he or she will make subjective judgments and intentionally or unintentionally impose his or her own subjectivity on others, leading to misunderstandings. For example, if a 16-year-old child in high school says one day that he doesn’t want to study anymore and wants to go out to work, parents will think that other children are studying and you are mentally ill if you don’t study, which is a problematic judgment. Therefore, to determine whether a person has a disease, first of all, from his personal inner harmony, and then from the two perspectives of harmony with the surrounding environment, and their own inner harmony is the first, the order should not be reversed. When encountering such confusion, family members need to bring the person to the clinic to receive professional psychological assessment and psychiatric examination to judge, rather than making arbitrary judgments based on their own feelings and prejudices. The second problem is that the patient does not admit to the disease and does not come to psychological treatment, what should I do? The patient’s series of manifestations confirm that he does have some psychological problems, such as social detachment, alienation from others, severe insomnia, and strange behavior. However, he does not admit to the problem and refuses treatment. First of all, legally, China promulgated the Mental Health Law a few years ago, which clearly stipulates that only two kinds of circumstances can force someone to receive treatment (involuntary treatment), one is to harm themselves to endanger their lives, and the other to harm others. Other than that, no one can force another person to receive treatment. This legal provision puts a person in a dilemma; the family is anxious to help him, but he refuses help and watches him ruin his life. In fact, the landing of the mental health law is epoch-making, as it guarantees that a person’s basic human rights are not violated. Although the dilemma mentioned above can arise, there is a need to be cautious about coercing others. In my clinical practice, this type of patient actually has some self-awareness at the very beginning, which means he is aware that something is wrong with him and has asked for help in the past, but the family often ignores or denies his request. It is only when the illness becomes severe that the family realizes the seriousness of the problem, and then it is too late to get him into treatment. In addition, some adolescent patients, often have relationship problems with their parents, have difficulty communicating with each other, or their parents also have psychological disorders or personality disorders that accumulate over time and lead to serious problems. By refusing treatment, the adolescent patient presents a deeper psychological meaning, namely, aggression and rebellion against the parents. So, it is not that he does not admit that he has a problem, but he wants to express a kind of anger in this way, and the parents rush the group and he gets some kind of release inside. At this point, what parents need to do is to improve their relationship with their child and get along well, not to go around seeking medical help and hoping that the doctor will come and force treatment, that will only complicate the child’s problems and lead to more serious emotional and personality disorders. The third question is, how do families want to become therapists themselves to help their patients? First of all, it is necessary to affirm that all of us are unconsciously “being treated” in our lives, which is also a socialization process, and we will become more and more mature. Those who are close to the vermilion are red, and those who are close to the ink are black. Assuming that Zhu is a healthy family member, a person will also become more and more healthy. For the ink person, a family member with a mental disorder, a person may also develop a mental disorder under this influence. For the Zhu person, the healthy family member, they face a patient with a psychological disorder, and there is no need to change anything, just be good enough, which care and support is a treatment in itself, no need to learn any more psychotherapy techniques. Because the mechanism of the occurrence of psychological disorders is very complex and not determined by a family member; for the inkling, that is, the family member with psychological disorders, if she becomes a psychologically healthy person and can help those around her, it takes a long process, and distant water cannot quench the thirst of the near. On the other hand, psychotherapy is to avoid dual relationships, and the misalignment of the relationship can lead to more serious problems. Therefore, instead of trying to become a psychotherapist, family members should try to be the person you should be, such as a mom, dad, wife or husband, taking up the responsibility of being a real and living person, which is more valuable than the psychotherapist status. In conclusion, psychotherapy is a technique and an art that enables a person to face his or her inner pain more courageously and become a real and unique person instead of a person being treated. Life is a long road, let’s explore it together.