It is a shame no one has responded to this posting all day. As a provider, I am seeing more people come into the places I work and note how they are stressed out with the financial issues at hand.

And no, I do not offer them a prescription when they tell me that socioeconomic matters drive them into treatment (what an ironic use here with gas prices up so much). But it is fascinating, if not irritating, how a significant portion of these people want a drug to make their problems go away.

Sometimes I just have to wonder how much more pathetic this culture can get, with this quick fix bs mentality and demand for fixing the "biochemical imbalance" due to the fact that someone can't pay their bills. Better living through chemistry; if only I could prescribe Jacksons and Franklins, eh?

I may be a psychiatrist, but as a patient so astutely said in my office today, "you are a person like me and you must get sick and tired of people expecting you to fix their problems like a serviceman."

Amen!!! It's nice to see people who respect the process of mental health care.

By the way, FS, cultural hard times lead to increased mental health morbidity and mortality.

I'd bet a sizeable portion, perhaps still a minority percentage but significant nonetheless, would survive, maybe even thrive, if the community would be supportive and not selfish. That, in my humble but experienced opinion, is at least partially due to what the internet has done to American culture at least.

Good story though!

This one is troubling, and conveniently TherapyFirst is the only other person to respond bringing up issues I'd wanted to find a comment of his (am I wrong in assuming you're male TP?) to respond to.

First, I think it's good that GMA is realizing that suicide, and the unbearable grief that I assume often precedes it (remember, no one has successfully interviewed a completed suicide so we're all speculating) is related to actual life events.

It's freaky that TP would feel anger at people who want the misery and humiliation brought about by economic misfortune stopped some how. Poverty hurts dude. Losing your job, and then your house and experiencing the emotional stress that goes along with it, cause severe emotional pain that ironically bleed into the rest of ones life making it much harder to perform appropriately on a job interview, on the bus, anywhere. It's human to want a pill to fix this. It's sick that someone who believes so strongly in therapy isn't volunteering at the local unemployment office to help people who are honestly grieving their actual real time loss of internal locus of control.

Still, I started in therapy as a kid, moving from hanging out in the waiting room while my mother was in "therapy" to getting my own session with the "psychologist." Then several years later grad school in counseling. Back when I was in school, the mid 80's, the big story was that therapy didn't work. Perhaps TP, you're too young to remember all of those studies and mainstream news reports. It was discovered therapists never told their patients they were well so they stayed in therapy forever, a total rip off. So, until I saw the debacle they've caused, I too was thrilled with the new drugs. And I think older more reliable drugs really can help if you're unhappy, at least help some people. I know people who've used marijuana to effectively manage the terror and such of poverty, however, this doesn't work for me as weed makes me anxious. A nice poppy tea every now and then works, but it's almost impossible to find poppies anymore and of course if I could find enough, the tea would lose its effectiveness as I became physically addicted.

Still therapy doesn't work. All depression is on some level caused by some problem, whether it's a bad economy, and the ensuing deprivations and unique perspectives, or the heartbreak of having a troubled drug addict for a mother. All of us have external problems that paying some dude lots of money so we can "do the work" won't fix. And a pill won't fix. Society long ago realized that being drunk on alcohol, while an appropriate temporary escape for some, was not a long term solution as when you sober up, not only do you still have the same problems you had when you starting drinking, but often, due to the nature of alcohol, you have done something while drunk to exacerbate the problems you had before you started drinking. Psych drugs are the same but worse as their side effects are more dangerous and the behavior changes they cause more subtle and insidious, and also of course because psych drugs are surrounded by the myth that if you're unhappy, you have a genetic flaw. Look for the drug companies to argue that the same genetic flaws that cause depression may also cause the lack of motivation that leads someone to poverty, oh and of course it's generational. I'll have to find my link to those evil stories about ptsd and Hurricane Katrina and depression, the being freaked out about losing everything in a flood is caused by a genetic weakness argument.

TP, what are you selling if not "fixing people?" If people are supposed to "fix themselves" without your intervention, what are you selling? A psychiatrist being angry because his patients want to be fixed is analogous to an auto mechanic complaining that all of his customers want him to fix their cars. FP, it's good your here, you seem to be on the right path, but I shudder to think of the carnage you leave in your wake, blaming your patients for their own troubles while simultaneously thinking that the victims of human tragedy owe you big bucks.

As on cue, read in the Health section of today's Baltimore Sun Newspaper (www.baltimoresun.com) the article that talks of the somatic and mental health impact from debt. Has nice statistics to show there is an effect.

TF i made it a personal goal not to medicate my life situation (bankruptcy)and worked with my psych to actually reduce anxiety med i am on,during the process and after a long and grueling 5 months of dealing with paperwork, feeling like a failure, all of the human aspect of this: my psych told me this week i'm doing better on less meds and is completely impressed with how i handled the situation(s)at hand. I was impressed with him not pushing pills and for being a positive force in my life. I simply refuse to allow bad stuff take me down, or become a statistic in the newspaper.

Not saying it was easy...it's been hell. But life is hell. (sometimes)

Replies to the above:

First, stephany, it sounds like you are problem solving well, so stick to what works. It often turns out that less meds, if not wean to discontinue, is a goal a good number of patients should pursue. Often when patients are acutely ill, they need a larger dose to get the desired effect, and when they are stable (and probably problem solving the multiple factors that played a role in getting ill in the first place), then meds can be lowered. It is applicable in most illnesses, somatic or psychological!

As to reading Sally's last comment, I have to say I get a mixed vibe from your responses to my comments. I've gone back and read most of my comments at different postings since I started writing to this blog site, and the only one that I was "angry" was my comment about Scientology. And, right or wrong, I will not rescind what I said: I don't like that organization and I have yet to meet someone who espouses their views who shows any tolerance to mental health care. I don't expect everyone to agree or support my profession, but the hate and intolerance from them is unacceptable. That position is non-negotiable, so I am sorry to say that, but I am honest and direct, so do what you will with this perspective.

I read what I wrote above and don't get the anger part you write about (I assume I am TP, I usually get initialled as TF). I do read your anger part, and I appreciate your sharing some of your experiences in treatment; to me that is taking at least a bit of a risk to speak about personal matters at a site like this, so I applaud your efforts. Your comment about volunteering at the unemployment office I don't get though. To do what, pass out cash or have a Lucy-like booth for 5 cent advice? I personally do not believe psychiatry is to treat poverty, but if people are impoverished because they are impaired in decision making because of dysfunctional mood or thought abilities, then maybe I could be of help.

This next comment probably will be misinterpreted, but it needs to be put out there irregardless: a therapist is like a catalyst (bit of chemistry here folks), to engage in a reaction that creates change without the catalyst itself being altered; an enzyme is a good example biologically. So, we meet with patients and enact change by having them take meds, consider different framing and coping mechanisms, and going out and acting on the changes and hopefully having a positive outcome.

So, yeah, I don't like "fixing people", because that framework diminishes what the process offers. I look at it as "people helping others help themselves". Because, let's be honest, if someone can fix themselves, he/she won't be coming to me in the first place.

Again, if what you do works, there is not a problem, true? Psychiatry is about treating dysfunction, plain and simple for me.

On a separate note, I am taking a sabbatical from work and the computer for 9 days starting tomorrow, so I won't be around to debate and relate. So, to stick with the rhyme, hope things are great and there's more love than hate.

good times, good luck, good day.

TF- I had a lot of support via emails from people and comments on my blog. Thus internet support, something that probably baffles you, I know!

I do have to quibble about the word 'dysfunction' you wrote...because I never stopped functioning, and most ppl don't even if they land in a psych office, they've made an effort dare i say, because they are functioning and you might consider thinking about it as "giving tools" or whatever, all I know is my psych was immediate to tell me I've always been "on target" through all of my hell. Just my 2 cents, which is probably too many.

Often when patients are acutely ill, they need a larger dose to get the desired effect, and when they are stable (and probably problem solving the multiple factors that played a role in getting ill in the first place), then meds can be lowered. It is applicable in most illnesses, somatic or psychological!

I'm confused with this statement.
It seems it works perfectly. A patient is prescribed a drug while acutely ill and the dose is increased till the "desired effect" is achieved and they are stable.

It looks as if this "desired effect" is something quite simple it's clear what a drug can promote.
What I see is people changing from drug to drug and not reaching this "stable" condition.

But let's assume that this drug helped and in a certain dose there comes stability.

The "multiple factors" that caused the disease will be treated not by the drug but the drug can promote a well being that empowers people to find the causes of their illness.

So the doses can be lowered.

In many posts of this blog people talked over and over again about the overwhelmingly struggle of tapering off.

But:
It is applicable in most illnesses, somatic or psychological!

I'm deeply confused.

That, in my humble but experienced opinion,

The only problem I see when a physician speaks about the "experienced opinion" is that sometimes it's far from what the patient experiences.

As a matter of fact the "experienced opinion" of the patient is seldom take seriously.

"-It's not the drug! It's psychological!"

I'm confused.

I forgot to say that the "experiences" of the patients are being reported daily on blogs which enables exchanging informations on treatments.

You know, I have to say that there is a lot of resentment being voiced by most of you as commenters. I said earlier, and I know I can't apologize for other's behaviors and actions, I am sorry some of you have shared being burned by providers. Nonetheless, if you want to generalize all psychiatrists have an "agenda", then wait until someone lumps you into one of their generalizations in a negative way. It is offensive when you don't know me, and I note up front making comments on a blog site is not the level of transparency one should expect and respect.

I'm not going to tell my life story here, but I will say this: I take the practice of medicine very seriously and believe strongly in the core two principles of the Hippocratic Oath--first do no harm, and go from least to most invasive.

Maybe while I am gone for the next week, it might be worth while stepping back and examining what your expectations are if you have patient needs.

A lot of you want to slam or challenge every comment I make. You know what I think? Some of the projections coming out here are very enlightening at the least. If you don't like or agree with what I say, fine. My agenda is to educate, enlighten, and be educated and enlightened. Hope this interaction provides faith and hope.

Have a nice week.

Statistically, mental "illness" does increase during economic hard times, which means that it is not a direct biological correlation. I have been in the position of apologising for my therapists' lack of ability to be of any use to me, but I look at this as a sign of my codependence. Really, some practical advice should not be too much to ask for the handsome payment received by the therapists.

TF,

Sorry if I confused you with FP (Flawed Plan). In many ways you guys have similar opinions, but you are certainly not identical. It's troubling that you think the anger and criticism you read here is a symptom of mental illness. You write: "A lot of you want to slam or challenge every comment I make. You know what I think? Some of the projections coming out here are very enlightening at the least." Dr. what if our anger is valid and not simply symtomatic? It's troubling that you see your negative comments about others as valid reality and our critiques of you as well, a symptom of mental illness. As for the dysfunction thing, I think Stephany, who still considers therapy valid, doesn't realize that all therapists consider anyone who gets into therapy as dysfunctional. What you don't realize doc is that lots of us went to therapy not thinking we were profoundly broken but to improve on our already valid lives, experiences, etc. It's you who teach us we're profoundly broken.

As for your alleging that pshrinks act as catalysts for change, but don't try to "fix" people, that is deliberate obtuseness, another harmful "psychotherapy" technique. Am I projecting or is that a harmful dishonest way to treat folks? Passive aggressive perhaps?

You profess to believe that dispair and depression are real parts of the human experience, that unemployment and a bad economy contribute to such and to voice your opinion that people who experience such painful emotions are sick and "need to do the work" with the help of a psychiatrist, catalyst, so why do you pretend not to understand what you should be doing, assuming you actually believe this, which I find unlikely, down at the unemployment office?

Is it an urban myth that psychiatrists had the highest rate of suicide of any profession until surpassed by dentists? I don't know but I think you need to find a way to focus on your own thoughts, feelings and impressions rather than blaming your "patients" and the folks who comment on this blog for your disappointment with life, to, as you request, be enlightened. You lump everyone who has ever seen a psychiatrist together in so many generalizations in a negative way and you seem completely unaware. Payback is hell.

Sally, in your comment to TF you stated that I still think "therapy is valid".

I have never made a comment regarding "therapy".(though i like the 'idea' of talk-based gut-spilling vs.meds any day!)

I admire TF for speaking out, and have been reading what he has to say for months on a different blog. As a professional he says a lot of candid stuff.

please know that I appreciate your comments (and you), and a forum where we can bounce ideas and thoughts from another without moderation!

Thanks Stephany. Sorry if I mischaracterized you. It's interesting to see TF so honestly express what most pshrinks think and don't say, sort of like listening to a person who is racist in an anti-racism workshop, painful, but the fact that he's here means he's making an effort which is good, but as you know I have a pretty radical view of psychiatry and consider the actions of someone who makes their living that way admirable.

TF,
I'm sorry. I just raise some questions.
I don't need to project nothing here. I'm on psychoanalysis, not therapy which is quite quite different, for 20 years.
I could quit but I don't exactly not to project my problems on other people.
You know well what psychoanalysis is to understand where "projections" are left if a person is under this process.
I raised questions and I said: "-I'm confused".
It was not irony.
I really got confused bu the questions I did.
Sometimes it's hard to know the difference between real questions and criticism disguised as irony.

"resentment".
I'm not resented any longer.
Not for me, not by what happened to me.
I've found a good psychiatrist and have no problems with it.
In my life as it's now.
But that doesn't mean I'll stop being critical about psychiatry. The psychiatry you know that is causing harm.
If I can help others knowing that they have to choose a real good psychiatrist because these drugs are very dangerous and can cause iatrogenic diseases I'll do whatever I can specially when children and adolescents are at stake.

Sally,
I don't know what you mean by "psychotherapy".
This word approaches so many different techniques that it seems to me that people don't know what good therapy is about.
I have already said it here.
When I see psychologists in US wanting to have a license to prescribe I don't know any longer where to draw the line that makes the difference between Therapy and psychiatry.
The way I see and use therapy has nothing, nothing to do with psychiatry.
And I doubt that a psychiatrist can make any good therapy. I've seem two and it was not good.
Therapy has nothing to do with giving advices or playing with words like we see in movies.
It has nothing to do with techniques like EMDR, CBT and others.
I've already said that.
It's not a place where you go to "receive" counseling.
It's something quite different.
And it works.
For those who like scientific proves a Canadian university, unfortunately I lost the link, has made a research showing that psychotherapy can reach the limbic system.
I don't need this kind of data. I believe that we are far from knowing what does it really means the brain to have a clue about what does it mean having the limbic system activated by any way and what is the result of that.
I believe all we have now represents the first step in knowing the brain.

Ana,

No one knows what psychotherapy means, anymore than we know what the highly subjective, pejorative labels bipolar and schizophrenic mean.

To me psychoanalysis isn't therapy and it's something I look forward to doing some day when I have the time and money. It seems to me all humans could benefit from psychoanalysis.

Before the new meds became common place I knew lots of people who were abused by forced therapy. I worked with people with industrial physical injuries, workers compensation clients. Sometimes one of the insurance defense lawyers, insurance adjusters, or I would recommend therapy/counseling whatever for one of the workers, particularly one who had a serious physical injury that would cause any human emotional distress. In theory this should have helped the person with their mental transition but in practice therapists didn't just belittle and demean clients, they also got the client to trust them so they could get the client to say something that would cause their worker's comp claim to be denied as the workers, no matter how many times I told them to the contrary could not believe that the therapist could and would share any confidences with anyone paid by the insurance company paying for the therapy. So someone who has lost their leg in an industrial injury is manipulated by the therapist into saying they were already unhappy before the injury. Depression, pre existing condition, or confessions of adultry, well then the injured worker can't go to court for his benefits because therapy notes are discoverable. Therapists are scum. TF's comments are seething with contempt for his "patients." That's pretty normal for a therapist whether a psychiatrist or psychologist in my opinion.

I think there's lots of studies and general agreement that people who have meaningful non abusive relationships with other people are happier and healthier than people who don't. Some improvement in some people who talk to therapists is because in some rare occasions talking to a therapist is better than talking to no one at all, but generally talk therapy is a waste of time and money and while I'm not one to need scientific proof, the fact that there isn't any strengthens my case. I'm all for peer support, support groups, and such, just not therapy. Here's a couple of books I like on the subject. I suspect you've heard of at least one of them: "They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal" by Paula J. Caplan and "Beware the Talking Cure: Psychotherapy May Be Hazardous to Your Mental Health" by Terence W. Campbell.

Sally,
I'm appalled by what I'm reading about therapy in US.
Therapy can be very hazardous. It's a real danger.
Manipulative techniques such as repressive memories can do a lot of harm.
Terence Campbell is a psychologist and I'm getting in touch with his work now.
I have already experience a bad psychoanalyst. But at least this one was so bad that he did you neither good or evil. (he he he)
However those who are good really helps.
I was luck to find the right person.
I have already heard about people who were in therapy here that claims that the therapist told them to do this or that and had already an "answer" to their problems.
This is not therapy!
Good therapy, at least this is my experience, is the work of two.
You have to conduct your therapy.
It does not mean that you're there talking the wall and the silence of the therapist means nothing. There are times when the therapist has something to say to you. But it's usually to make you see you YOU have said.
It's a hard job to explain the therapeutic process.
I'll try to translate some of the stuffs I have written about it.
I don't know too much about therapists in US.
I'm even asking some people about it because it seems to me that psychologists, I don't like too much psychology I prefer psychoanalysts but perhaps it's a question of our difference in culture.
I'm not understanding hearing so many reports of terrible experiences from some people.
And I'm also concerned about the ties between therapy and psychiatry.
It's impossible to discuss medicaments during your "time".
The question about the money: my therapist does not charge for a long time.
One of the reasons is my obvious lack of money.:)
The other has to due with my life.
Hope it helps.
And give me some information about what is going on in US!

I've remembered that now there's something called "Philosophical Counseling".
LOL
lol

I have no words...

Ana,

I haven't looked into it but I'd imagine you are right that there's a cultural and maybe semantic difference in who gets called a psychologist and who a psychoanalyst. The thing I don't like about therapy is that the ideal egalitarian relationship where both people work equally for the psychological improvement of the one that is paying is a human impossibility. When psychology became a cottage industry, at some point I assume in the 20th century, this seems to have been the goal of many well intentioned people but unfortunately no progressive movement in the US in the first half of the 20th century can be separated from the Eugenics movement so all therapists came into their work looking for that certain patient that is a mental defective that would literally be better off dead than alive or at least sterilized and institutionalized. Consider TherapyFirst's handle, Therapy first. It's like he's a frustrated father saying to his kids, first we're going to try sending you off to bed with no dessert and if that doesn't work.....what's second Therapy First and aren't you lucky to be the only one sane enough to decide?

There's another guy whose blog Phillip has a link to, EveryoneNeedsTherapy. I think I once suggested to this person that the name of the blog should be changed to EveryoneButMeNeedsTherapy as that would be an accurate reflection of that person's view.

I'm pretty adept at the therapeutic process having received graduate training in therapy. I'm told I'm a gifted therapist, but it's something I'd never do for a living. When one person gets paid and keeps records on the other person there's no equality.

I'm glad therapy is working for you. Not all therapists are bad. I'll snake out of this corner by saying that if your therapist doesn't charge you, s/he's not really a therapist but instead a really good friend. That's what this world needs, more good friendships. Still this is just my opinion. I have no right to denigrate your relationship with your therapist or anyone else's for that matter, but I feel that I have a duty to speak out about my experiences and thoughts in this realm, as we all do.

The study of psychology and the human brain is a worthwhile pursuit but institutionalizing it as on the streets therapy a human mistake. Look at what happened in the USSR, in China, what's happening here in the US. Time to stop.

In Georgia last week there was another in the series of articles in the Atlanta Journal Constitution (ajc.com) on the deplorable state of the entire "state mental health system." First in the series, the article about how people legally forced into these state psych hospitals here would be safer outside of the facilities due to all of the rape, murder, etc. that occurs in these facilities. Then a bit later in the week we get a story about how wrong it is that the governor is cutting money for child mental health services. I think the cutting of money is good news as it means less money to identify victims to later be killed in psych hospitals, to spend a lifetime of surveillance and control at the hands of incompetent state "mental health counselors" while being forcibly intoxicated on drugs that rob them of self control and an ability to perceive reality.

As for the financial relationship between psychologists and psychiatrists, in the states I know about only psychiatrists have prescribing privileges and hence you usually see a psychiatrist and psychologist in practice together. Whichever one you go to first sends you to the other because they are business partners. And when your psychologist who is business partners with your psychiatrist suggests that you see the psychiatrist, psychologist speak for you need pills nutcase, it's more than a suggestion. When the psychiatrist suggests that you see the psychologist s/he means the one in practice with her/him. In both cases, you do what your pshrink says or they discontinue you (unless you have really deep pockets). I think there are some states where psychologists have prescribing privileges and I hear social workers are also lobbying for prescribing privileges. I don't know how this effects their for profit and/or government run mental health industries.

Sally,
I wrote you a long answer but I lost it for I didn't wrote it here on the site.
I was writing on the notebook so that it could be easier to read your comment and answer your points.

We are having the same discussion on the other post.

Yesterday I was tired and I was going to say that:

By saying that she doesn't charge me you might think that whether she's not a good therapist or we became friends.
No.
She is a good pro and if it had happened she would stop.
Each case is one case and I would even like to stress that the good psychoanalysts we have here are not rich and they live a quite modest life instead.
Psychoanalysis and psychology are two different approaches. This is not a question of semantics. It's real.
I don't see any reference of a psychoanalyst on US.
I see even psychologists who are critics of the psychology.
It's unthinkable for a psychoanalysts medicate.
It's too complex.
We have to exchange ideas little by little.
I totally agree with you on what you wrote on the last two paragraphs.

"The study of psychology and the human brain is a worthwhile..."

If you think of psychology as tests for this of for that... it means nothing. Easy therapies to achieve some goals is good for some problems but does not for all.
The study of the brain: it has just born.
I truly believe we know nothing.
Nothing.
Mapping the brain is far from giving any evidence of any kind.
The brain has it's chemistry which knowledge is also starting to develop.
Electrical chains...
yada yada yada... I don't trust any claim assuring this or that.
I even dare to say that it's not only the brain that is to blame.
The whole body has to be highly understood.
You know about some people who received a transplant and have memories from the person whose organ belonged.
I'm imagining in, let's say 3.013...
They will have too much to laugh about.
In other words: we were born in the wrong era.
:(

As Oscar Wilde used to say:
"The world is a stage, but the play is badly cast. "
or
"Why was I born with such contemporaries?"

:)
You know we have to make a quote on this topic to have our words validated.

You didn't left a quotation...
Please Sally!
{laughing like Stan}
Where's Poe?
Where are you Poe!
Have you opened the Blog?
Don't be homeless on the blogosphere all of you.
It's good to visit friends!