I was standing in one of the aisles at ASDA, scanning for coconut oil, when I saw them. The word macaroons was stamped on the side of tiny, forlorn-looking boxes, tucked away on the bottom-most rack at an unbelievably reasonable price for macarons. I reached for one excitedly, only to realise it was not what I had been expecting at all.
That was when it dawned on me, after a brief moment of befuddlement and a quick spot of Googling, that for most of my life I have been confusing macarons and macaroons.
They sound almost identical. They look nothing alike. They are, in fact, two entirely different things.
One is delicate, French, and temperamental, requiring precision, patience, and no small amount of technical skill. The other is sturdier, historically more forgiving, coconut-based, and far less likely to collapse if conditions are not exactly right.
Neither is better. But mistaking one for the other usually ends in mild disappointment, as it did for me.
I smiled to myself in the aisle, because my mind did what it often does. It wandered back to psychiatry.
More specifically, to how often people confuse psychiatrists, psychologists, and psychotherapists. Sometimes interchangeably, sometimes confidently, and almost always without malice.
Just last week, a Malaysian barrister practising in the United Kingdom, whom I met socially while visiting friends in London, kept referring to me as a psychologist. I corrected him gently. Twice.
By the third time, he admitted, quite unabashedly, that he did not actually know the difference. He was not being dismissive or arrogant. He was simply honest.
In fact, he had just finished eloquently explaining the distinction between a solicitor and a barrister, and why each cannot simply do the work of the other. Which I thought was a fair and accurate assessment.
And yet, when it came to psychiatry and psychology, both professions collapsed in his mind into a single activity. Talking to patients.
He is far from alone.
This is not a line I hear for the first time. Friends, patients, relatives, acquaintances, and even other professionals regularly reduce all mental health roles into one vague category. Someone you talk to about feelings.
Much like macarons and macaroons, the similarity in sound disguises the reality that these are distinct professions, with different training pathways, responsibilities, and scopes of practice.
So what is the difference?
A psychiatrist is a medical doctor. We go through medical school, housemanship, also known as foundation training, and then years of specialist training in psychiatry.
We are trained to diagnose mental illness, assess risk, manage complex and often acute presentations, and prescribe medication. We work at the interface of mind and body, where depression meets thyroid disease, where psychosis meets epilepsy, and where trauma intersects with neurobiology. We are often involved when someone is at their most unwell.
A psychologist, on the other hand, is not a medical doctor. Psychologists are highly trained specialists in human behaviour, cognition, and emotional processes.
They are experts in psychological assessment, formulation, and therapy. Many conduct detailed cognitive testing, developmental assessments, and evidence-based psychological interventions. Their training is different, but no less rigorous within its own domain.
A psychotherapist usually refers to someone trained in a specific therapeutic modality, such as psychodynamic therapy, cognitive behavioural therapy, or systemic therapy.
In Malaysia, psychotherapists and counsellors often work within overlapping professional frameworks, though their training routes, depth of specialisation, and scope of practice may differ.
Some counsellors are trained psychotherapists, while others practise more supportive or short-term therapies. The title alone does not always capture the full extent of a practitioner’s training, supervision, or clinical focus.
All three roles are valuable. All three are necessary. But they are not interchangeable.
So why does the confusion persist?
Partly, it is linguistic. The words sound similar. Partly, it is cultural. Mental health work is often portrayed as a single activity, talking. And partly, it reflects a broader discomfort with nuance. It feels easier to collapse distinctions than to sit with complexity.
But the distinction matters.
It matters because people seek help for different needs. Crisis versus reflection. Diagnosis versus understanding. Medication versus therapy. It matters because mismatched expectations can lead to frustration, delay, or disengagement.
And it matters because mental health care, like pastry, is best appreciated when you know what you are actually getting.
Confusing a psychiatrist for a psychologist does not offend me. Much like my macaron and macaroon revelation, it amuses me more than it irritates me. But it does remind me how much work remains in helping the public understand what mental health professionals actually do.
At the end of the day, both macarons and macaroons are sweet. Both psychologists and psychiatrists help people suffer less. But knowing the difference allows you to appreciate each for what it truly is.
And perhaps, the next time someone corrects you gently, it is not an indictment of ignorance, but simply an invitation to learn the difference between two things that sound alike, yet serve very different purposes.
The author is a psychiatrist.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
