When I was asked to endorse a new book on the Enneagram, I saw the author had bad-mouthed psychology in general and the American Psychiatric Association in particular in his introduction. His objection was that, according to him, the psychology profession always prescribes drugs instead of talk therapy. In my experience, that just isn’t true. While many of us try to avoid pills, we know that sometimes they save the day. I told the author his blanket condemnation of the psychology profession was unwarranted and he’d have to delete it if he wanted my endorsement.
According to Brandon A. Gaudiano in a September 2013 article in the New York Times titled "Pychotherapy’s Image Problem," the American Psychiatric Association does indeed promote drugs as the treatment of choice. The American Psychological Association, however, promotes psychotherapy as the treatment of choice. In his article, Gaudiano said outpatients in mental health facilities receiving psychotherapy alone fell by 34 percent from 1998 to 2007, while those receiving medication alone increased 23 percent.
Gaudiano also pointed out that even though psychotherapies have been proven to work better than drugs for depression and anxiety, “primary care physicians, insurers, policy makers, the public and even many therapists are unaware of the high level of research support that psychotherapy has. The situation is exasperated by an assumption of greater scientific rigor in the biologically based practices of the pharmaceutical industries—industries that, not incidentally, also have the money to aggressively market and lobby for those practices.
“For the sake of patients and the health care system itself, psychotherapy needs to overhaul its image, more aggressively embracing, formalizing, and promoting its empirically supported methods.” Gaudiano added that psychotherapy should be the first choice because it usually produces good results and doesn’t have side-effects. Also, it prevents relapse better than does medication.
When people choose pills first instead of psychotherapy it’s because of a combination of what they can get and their lack of knowledge of what’s good for them. Another choice some people make to help them with their problems, however, can turn out to be a disaster: psychics. In "At the Trial Of a Psychic, It’s Awkward For Her Clients," (New York Times October 2013), Michael Wilson tells about two clients of psychic Sylvia Mitchell, who is now on trial for larceny. One client gave Mitchell $27,000 and the other gave her more than $120,000. Ms. Mitchell told the first one she had been an Egyptian princess in a former life. The second one said she needed answers and had no one else to talk to.
Gaudiano concludes that it’s important for therapeutic services and expenditures must be based on the best available research if people are going to choose them. “Many of psychotherapy’s practices already meet such standards. For the good of its patients, the profession must fight for the parity it deserves.”
• See my blog, Young People Talk about the Enneagram and Death.
• Read my blog about healing PSTD in Psychology Today Oct. 1.
• Visit “The Happy Introvert” on Face Book.
• Check out my work on wagele.com.