Category: Anxiety

Medication

Business Logo for Psychological and Neuropsychological IssuesThe use of legal psychoactive drugs has increased twenty two percent in the nine years between 2001 and 2010.  This is a truly staggering increase.  Most of the increased prescribing is performed by general practitioners-not psychiatric physicians.  Most people do not realize that psychiatrists attend medical school like other physicians.  After they graduate, psychiatrists receive special training within the field of mental health.  Non-psychiatric physicians have a few months of study and clinical training in mental health.  This is not intended to demean medically oriented physicians.  One can master only so much in a limited amount of time.  Most of the problem is not the limited training of physicians, rather it is the beliefs held by the public at large.

Many medically-oriented physicians believe particular patients would gain more from psychotherapy than medication; however, most patients are taken aback by a psychology referral.  Patients may believe that the doctor secretly thinks they are crazy or beyond the help of medication(s).  In addition, most people believe that psychotherapy takes years, or even a lifetime, to be effective.  It evokes images of the psychoanalytic couch, or worse, the snake pit of inpatient treatment.  Perhaps the psychologist will discover a hidden psychosis; a primal fear of many normal people.  Perhaps the psychologist seeks to relive one’s horrid memories until they are no longer able to function.  What about the fear of entrusted secrets to a near stranger?  Perhaps the psychologist discusses their crazy patients as entertainment.  Once the information is poured out of the bottle, who can say where all the drops will collect.

The beliefs of many psychologists may also interfere with the use of psychotherapy over medications.  A lauded professor of psychology, as well as practicing clinician, bemoaned the invention of Prozac as the death of psychotherapy.  This was bemoaned in 1990, long before the limitations and risks of the new antidepressants became known.  It is often difficult for the clinician to see progress in some patients, such that the use of a magic substance is very attractive.  The doctor would feel more secure and effective with something that promises to accelerate  the relief experienced in the office.  Early research suggested that psychotherapy is only effective for mild cases of anxiety or depression, and many clinicians still believe this to be true.  If medication was truly more effective than psychotherapy, psychologists would be guilty of misleading the public at large.  The outpatient practice of psychotherapy would effectively be a conspiracy against the public.
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Perhaps the easiest explanation for the rise of drug treatment is that insurance reimbursement for psychotherapy is lower and harder to obtain than that for drugs.  From the mid 1990’s to the mid 2000’s, the drug companies tripled their marketing of psychoactive drugs.  It has shaped the perceptions of the American public, and likely many professionals as well.  The drug companies do not have to make deceitful claims about their products.  Saturating the airwaves with pictures of happy attractive people taking their medications is sufficient to mold the unconscious mind.  Saturating the airwaves with happy attractive psychotherapy patients is not likely to occur in the near or distant future.  No one individual or company would profit from the endeavor.  There is no market pressure to push psychotherapy, such that it is shoved to the sidelines.

Convincing people to buy what they don’t need is at the center of American marketing genius.  The public apprehension regarding psychotherapy and psychologists energizes and assists the marketing of drugs.  Few patients weigh the benefits of psychotherapy over medication, since they are not presented with useful information.  Just as the nation woke from a Valium haze in the 80’s, the public is beginning to realize it has been oversold.  Wake up and evaluate the options for mental health treatment-you may be pleasantly surprised.

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categories Anxiety, Depression, Psychology | | datetime June 21, 2012 2:29 pm | comments Comments Off on Medication

Empathic Listening

Business Logo for Psychological and Neuropsychological IssuesEmpathy may be defined as the identification with the thoughts, feelings and attitudes of another person.  It sounds like something people experience every day, but it is more an exception than the rule.  If empathy was the rule, the norm, the world would be a much different place.  Empathy runs counter to the human need for people to differentiate themselves from other people.  It runs counter to the need for groups to differentiate themselves from other groups.  It is the proverbial act of putting oneself in the shoes of another person.  Psychotherapists often label the active process of  this identification as empathic listening.

The meaning of empathy is not synonymous with sympathy.  Sympathy is to be in agreement with the thoughts and feelings of another; even to share similar thoughts and feelings as the other person.  This is not the goal of most psychotherapeutic schools, since it may bring a loss of objectivity.  For example, a depressed person may engage in many thoughts and beliefs that enable the depression to flourish.  A sympathetic psychologist may become lost in the many instances of bad luck or even tragedy that befall the person.  Sympathy will render the psychologist blind to the maladaptive aspects of the patient’s behavior, since they are actively and uncritically ingesting the depression of their patient.  Similarly, an anxious patient may experience many negative outcomes as a consequence of their anxiety.  A psychologist that chronically feels sorry for their anxiety is certainly sympathetic, and this may serve to validate the patient’s perceptions, but it is unlikely to alleviate their anxiety in a meaningful fashion.

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Empathic listening is less a trait possessed by gifted people than a skill that is learned in a rigorous fashion.  Training to become a psychologist requires many hours of clinical supervision.  Students bring in tapes of psychotherapy sessions and the professors rake the students over the coals of their psychopathology.  It is not uncommon for many students to cry or become angry at the professor’s comments, since they may strike at the heart of what makes us a person.  No one likes to hear someone they respect say, “Why the hell did you say that?”  It is even more threatening when the professor gives a short description of the student’s pathology, and how their mistake will derail the psychotherapy.  It is a highly uncomfortable and valuable process when performed diligently.  It more comfortable and less useful if the professor seeks to spare the student’s feelings-to sympathize with their plight.  Empathic listening is a skill that every competent psychologist must acquire.  Empathic listening is a major factor that differentiates psychotherapy from ordinary conversation.  As a general rule, friends are sympathetic and shrinks are empathetic.

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categories Anxiety, Depression, Psychology | | datetime May 19, 2012 11:18 am | comments Comments Off on Empathic Listening

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