Medical psychology is a very broad field and has been defined in various ways. The Academy of Medical Psychology's definition applies to both the practices of consultation and prescribing in Medical Psychology, when allowed by statutes. These professionals are trained in a specialty of psychology concerned with the application of psychological principles to the practice of medicine and both physical, as well as, mental disorders. They apply psychological theories, scientific psychological findings, and techniques of psychotherapy, behavior modification, cognitive, interpersonal, family, and life-style therapy to improve the psychological and physical health of the patient. Clinical psychologists with post doctoral specialty training as medical psychologists are the practitioners with refined skills in clinical observation in of the field of psychology, learning, central nervous system adaptation and change, and adaptation and lifestyle change applying a number of different methods in several different mediums of treatment. These highly qualified and post graduate specialized doctors are trained for service in primary care centers, hospitals, residential care centers, and long-term care facilities and in multidisciplinary collaboration and team treatment. They are trained and equipped to modify physical disease states and the actual cytoarchitecture and functioning of the central nervous and related systems using psychological and pharmacological techniques (when allowed by statute), and to provide prevention for the progression of disease having to do with poor personal and life-style choices and conceptualization, behavioral patterns, and chronic exposure to the effects of negative thinking, choosing, attitudes, and negative contexts. (http://www.amphome.org/MedPsychDef.pdf)

Medical psychology may also refer to a growing specialty area of clinical psychological practice in which clinical psychologists, who have undergone specialized education and training at the post-doctoral level, integrate somatic and / or psychotherapeutic modalities into the management of mental illness. In the United States, New Mexico and Louisiana, and all branches of the U.S. uniformed services currently authorize medical psychologists to prescribe medications. In Louisiana, the term of medical psychologist refers, in statute, specifically to those psychologists licensed by the Louisiana State Board of Medical Examiners and who are authorized and licensed to prescribe medications. The term mirrors precisely the terminology of the United States Drug Enforcement Administration (DEA). In 2009, psychologists with prescriptive authority in Louisiana had the regulation of their practice of medical psychology and psychology transferred to the Louisiana State Board of Medical Examiners. Louisiana is the only state in the U.S. where a medical board has authority over the regulation of the entire practice of psychology (for medical psychologists). It is important to note that the American Psychological Association, Division 38 of the American Psychological Association and The Academy of Medical Psychology does not agree or recognize that the term medical psychologist has, as a prerequisite, the ability, certification, or licensure to prescribe medications in the care and management of patients nor should the term be equated with having prescriptive authority. (http://www.health-psych.org/MedPsych.cfm) (http://www.amphome.org/MedPsychDef.pdf)

Behavioral Medicine (related to Behavioral Health, Clinical Health Psychology and Psychosomatic Medicine) is a related branch of clinical practice in which psychologists emphasize the biopsychosocial approach to medicine, a model which recognizes the importance of addressing the interaction between physical, psychological and social factors in both the prevention and management of disease. Practitioners of behavioral medicine differ from medical psychologists in that they focus on the scientific application of behavioral interventions to a wide variety of medical conditions (e.g., asthma, gastrointestinal illnesses, cardiac conditions, spinal cord and brain injuries, chronic pain, headaches, and addictive illness).

Definitions[link]

Medical psychology, as defined by most medical dictionaries is defined as "the branch of psychology concerned with the application of psychological principles to the practice of medicine". Other similar definitions include: "the application of clinical psychology or clinical health psychology, usually in hospital, medical, or health care settings" and "the study and application of psychological factors related to any and all aspects of physical health, illness, and its treatment at the individual, groups, and systems level"

Medical psychology, as defined by Division 55 of the American Psychological Association (APA), "is that branch of psychology that integrates somatic and psychotherapeutic modalities into the management of mental illness and emotional, cognitive, behavioral and substance use disorders." Division 55 is the organization within APA that represents medical psychologist who have prescriptive authority and is a leader in defining this new practice area for clinical psychological practitioners with prescriptive authority.

The Academy of Medical Psychology defines medical psychology as a specialty trained at the post doctoral level and designed to deliver advanced diagnostic and clinical interventions in Medical and Healthcare Facilities utilizing the knowledge and skills of clinical psychology, health psychology, behavioral medicine, psychopharmacology and basic medical science. (http://www.amphome.org/MedPsychDef.pdf)

A specialty of medical psychology has established a specialty board certification, American Board of Medical Psychology and an Academy of Medical Psychology (http://www.amphome.org/) requiring a doctorate degree in psychology and extensive post doctoral training in the specialty and the passage of an oral or written examination, as does The International College of Professional Psychology (ICPP), (http://www.icpppsych.com) which is a Board Certifying Diplomate Fellow Credentialing Organization approved by the Florida State Licensing Psychology Board.

Although the Academy of Medical Psychology defines medical psychology as a "speciality" and has established a "specialty board certification," it is important to note that the American Psychological Association does not currently recognize medical psychology as a "specialty." However, Louisiana does indeed recognize this area of expertise by statute (the Medical Psychology Practice Act) as a "profession of the health sciences" with prescriptive authority. It is equally as important to note than the American Psychological Association does not recognize that term medical psychology has, as a prerequisite, nor should the term be equated with having, prescriptive authority. In fact, no other organization in the world, outside of Louisiana statute and the Louisiana Academy of Medical Psychology, equates medical psychology with prescriptive authority, as a prerequisite.

Education[link]

In 2006, the American Psychological Association (APA) recommended that the education and training of medical psychologists, who are specifically pursuing one of several prerequisites for prescribing medication, integrate instruction in the biological sciences, clinical medicine and pharmacology into a formalized program of postdoctoral education.

The following Clinical Competencies are identified as essential in the education and training of medical psychologists:

I. Basic Science: anatomy, & physiology, biochemistry;

II. Neurosciences: neuroanatomy, neurophysiology, neurochemistry;

III. Physical Assessment and Laboratory Exams: physical assessment, laboratory and radiological assessment, medical terminology;

IV. Clinical Medicine and Pathophysiology: pathophysiology with emphasis on the principal physiological systems, clinical medicine, differential diagnosis, clinical correlation and case studies, chemical dependency, chronic pain management;

V. Clinical and Research Pharmacology and Psychopharmacology: pharmacology, clinical pharmacology, pharmacogenetics, psychopharmacology, developmental psychopharmacology;

VI. Clinical Pharmacotherapeutics: professional, ethical and legal issues, combined therapies and their interactions, computer-based aids to practice, pharmacoepidemiology;

VII. Research: methodology and design of psychopharmacology research, interpretation and evaluation, FDA drug development and other regulatory processes.

The 2006 APA recommendations also include supervised clinical experience intended to integrate the above seven knowledge domains and assess competencies in skills and applied knowledge.

The above prerequisites are not required or specifically recommended by APA for the training and education of medical psychologists not pursuing prerequisites for prescribing medication.

The national psychology practitioner association (NAPPP; www.nappp.org)and top national certifying body (Academy of Medical Psychology; www.amphome.org)have established the national training, examination, and specialty practice criterion and guidelines in the specialty of Medical Psychology and have established a national journal in the specialty. Such certifying bodies, view psychopharmacology training (either to prescribe or consult) as one component of the training of a specialist in Medical Psychology, but recognize that training and specialized skills in other aspects of the treatment of behavioral aspects of medical illness, and mental illness affecting physical illness is essential to practice at the specialty level in Medical Psychology. The Louisiana Academy of Medical Psychology (LAMP), currently the largest organization of psychologists with prescriptive authority in the world and the only organization representing practitioners of medical psychology in Louisiana as defined by Louisiana statute within any jurisdiction in the United States, no longer recognizes the Academy of Medical Psychology as an adequate certifying body for its practitioners, and its members have resigned from the Academy of Medical Psychology en masse.

See also[link]

• Prescriptive authority for psychologists movement
• Health psychology
• Psychiatry

External links[link]

• http://www.health-psych.org/MedPsych.cfm
• http://division55.org/ American Psychological Association - Division 55 - American Society for the Advancement of Pharmacotherapy
• http://icpppsych.com International College of Professional Psychology
• http://nappp.org/ National Alliance of Professional Psychology Providers
• http://www.amphome.org/ Academy of Medical Psychology
• http://www.rxp.nappp.org/ National Alliance of Professional Psychology RxP Training Program
• http://www.abbhp.org/ American Board of Behavioral Health Practice
• http://www.nibhq.org/ National Institute For Behavioral Health Quality
• http://division55.org/ContinuingEducation.htm Postdoctoral training programs in clinical psychopharmacology
• http://www.apapractice.org/apo/insider/professional/psychopharmacology.html# Psychopharmacology Examination for Psychologists (PEP)
• http://division55.org/TabletOnline.htm Division 55 newsletter "The Tablet"
• http://www.medicalpsychology.nl Department Medical Psychology Tilburg University The Netherlands

Rollo May (April 21, 1909 – October 22, 1994) was an American existential psychologist. He authored the influential book Love and Will during 1969. He is often associated with both humanistic psychology and existentialist philosophy. May was a close friend of the theologian Paul Tillich. His works include Love and Will and The Courage to Create, the latter title honoring Tillich's The Courage to Be.

Biography[link]

May was born in Ada, Ohio in 1909. He experienced a difficult childhood, with his parents divorcing and his sister becoming schizophrenic. He was the first son of a family with six children. His mother often left them to care for themselves, so with his sister being a schizophrenic, he endured a great deal of responsibility.^[1] His educational career took him to Michigan State College majoring in English and Oberlin College for a bachelor's degree, teaching for a time in Greece, to Union Theological Seminary for a BD during 1938, and finally to Teachers College, Columbia University for a PhD in clinical psychology during 1949. May was a founder and faculty member of Saybrook Graduate School and Research Center in San Francisco.^[2]

He spent the final years of his life in Tiburon on San Francisco Bay, where he died in October 1994.

Accomplishments[link]

May was influenced by American humanism, and interested in reconciling existential psychology with other philosophies, especially Freud's.

May considered Otto Rank (1884-1939) to be the most important precursor of existential therapy. Shortly before his death, May wrote the foreword to Robert Kramer's edited collection of Rank’s American lectures. “I have long considered Otto Rank to be the great unacknowledged genius in Freud’s circle,” wrote May (Rank, 1996, p. xi).

May used some traditional existential terms in a slightly different fashion than others, and he invented new words for traditional existentialist concepts. Destiny, for example, could be "thrownness" combined with "fallenness"— the part of our lives that is determined for us, for the purpose of creating our lives. He also used the word "courage" to signify resisting anxiety.

He defined certain "stages" of development:

• Innocence – the pre-egoic, pre-self-conscious stage of the infant. An innocent is only doing what he or she must do. However, an innocent does have a degree of will in the sense of a drive to fulfill needs.
• Rebellion – the rebellious person wants freedom, but does not yet have a good understanding of the responsibility that goes with it.
• Decision – The person is in a transition stage in their life such that they need to be more independent from their parents and settle into the "ordinary stage". In this stage they must decide what to do with their life, and fulfilling rebellious needs from the rebellious stage.
• Ordinary – the normal adult ego learned responsibility, but finds it too demanding, and so seeks refuge in conformity and traditional values.
• Creative – the authentic adult, the existential stage, self-actualizing and transcending simple egocentrism.

These are not "stages" in the traditional sense. A child may certainly be innocent, ordinary or creative at times; an adult may be rebellious. The only association with certain ages is in terms of importance: rebelliousness is more important for a two year old or a teenager.

May perceived the sexual mores of the 1960s and 1970s, as well as commercialization of sex and pornography, as having influenced society such that people believed that love and sex are no longer associated directly. According to May, emotion has become separated from reason, making it acceptable socially to seek sexual relationships and avoid the natural drive to relate to another person and create new life. May believed that sexual freedom can cause modern society to neglect more important psychological developments. May suggests that the only way to remedy the cynical ideas that characterize our times is to rediscover the importance of caring for another, which May describes as the opposite of apathy.

His first book, The Meaning of Anxiety, was based on his doctoral dissertation, which in turn was based on his reading of the 19th century philosopher Søren Kierkegaard. His definition of anxiety is "the apprehension cued off by a threat to some value which the individual holds essential to his existence as a self" (1967, p. 72). He also quotes Kierkegaard: "Anxiety is the dizziness of freedom". In 1956, he edited the book Existence with Ernst Angel and Henri Ellenberger. Existence helped introduce existential psychology to the US.

“Love and Will” is another of May’s famous texts. This book investigates the shifting viewpoints of love and sex in human behaviour. During the “Sexual Revolution” in the 1960s, many individuals were exploring their sexuality. “Free sex” was replacing the ideology of free love. May explains that love is intentionally willed by an individual, whereas sexual desire is the complete opposite. Real human instinct reflected upon deliberation and consideration^{[clarification needed]}. May then shows that to give in to these impulses does not actually make one free, but to resist these impulses is the meaning of being free.

Criticism of Modern Pyschotherapy[link]

May believed that psychotherapists in the late 1900's had fractured away from the Jungian, Freudian and other influencing psychoanalyst thought and started creating their own 'gimmicks' causing an crisis within the world of psychotherapy. These gimmicks were said to put too much stock into the self where the real focus needed to be looking at 'man in the world'. To accomplish this, May pushed for the use of existential therapy over individually created techniques for psychotherapy. ^[3]

Bibliography[link]

• The Meaning of Anxiety (1950), W W Norton 1996 revised edition: ISBN 0-393-31456-1
• Man’s Search for Himself (1953), Delta 1973 reprint: ISBN 0-385-28617-1
• Existence (1956), Jason Aronson 1994 reprint: ISBN 1-56821-271-2
• The Art of Counseling (1965), Gardner Press 1989 rev. edition: ISBN 0-89876-156-5
• Psychology and the Human Dilemma (1967), W W Norton 1996 reprint: ISBN 0-393-31455-3
• Love and Will (1969), W W Norton ISBN 0-393-01080-5, Delta 1989 reprint: ISBN 0-385-28590-6
• Power and Innocence: A Search for the Sources of Violence (1972), W W Norton 1998 reprint ISBN 0-393-31703-X
• Paulus. A personal portrait of Paul Tillich (1973), Harper & Row ISBN 0-00-211689-8
• The Courage to Create (1975), W W Norton 1994 reprint: ISBN 0-393-31106-6
• Freedom and Destiny (1981), W W Norton 1999 edition: ISBN 0-393-31842-7
• The Discovery of Being: Writings in Existential Psychology (1983), W W Norton 1994 reprint: ISBN 0-393-31240-2
• My Quest for Beauty (1985), Saybrook Publishing ISBN 0-933071-01-9
• The Cry for Myth (1991), Delta 1992 reprint: ISBN 0-385-30685-7
• The Psychology of Existence (1995) (with Kirk Schneider), McGraw-Hill ISBN 0-07-041017-8

See also[link]

• Stephen A. Diamond
• Abraham Maslow
• Carl Rogers
• Virginia Satir
• Kirk J. Schneider

References[link]

• Rank, Otto (1996). A Psychology of Difference: The American Lectures [talks given 1924–1938; edited and with an introductory essay by Robert Kramer]. Princeton University Press ISBN 0-691-04470-8

1. ^ American Psychologist (April 1996), 51 (4), pg. 418-419. <http://resolver.scholarsportal.info.myaccess.library.utoronto.ca/resolve/0003066x/v51i0004/418_rm>.
2. ^ Saybrook: Historical Origins
3. ^ May, Rollo. (October 2009) Rollo May on Existential Therapy. Volume 49 Number 4. Journal of Humanistic Psychology. 419-434.

External links[link]

Primary Sources

• The Meaning of Anxiety By Rollo May, 1950, 1977, 1996
• The Courage to Create, by Rollo May, 1975
• Man's Search for Himself , By Rollo May, 1953, 1981, 2009
• The Discovery of Being: writings in existential psychology By Rollo May, 1983

Secondary Sources

• Famous Psychologists - Rollo May
• Rollo May page at Mythos & Logos
• Thinking Allowed - Interview with Rollo May Ph.D.
• Saybrook Graduate School's Historical Origins
• "Personality Theories - Rollo May"
• "Existential Primer: Rollo May"

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