Being Therapeutic: Re-examining the “Biological Paradigm” in Psychiatric Training and Clinical Practice

Psychiatric training in India emphasises a biological paradigm, with minimal focus on psychological formulation or psychotherapeutic methods. Yet many psychiatrists engage in implicitly therapeutic practices without formal training. This paper explores the distinction between “doing psychotherapy” and “being therapeutic,” highlighting the roles of psychological formulation and therapeutic alliance in clinical care. These often-unspoken practices influence patient outcomes, satisfaction, and treatment adherence. We argue for greater recognition and development of these skills within psychiatric training and practice. Emphasising relational dynamics and repeated, flexible encounters may enhance care, especially in resource-limited contexts where formal psychotherapy is less feasible.