I was talking to my neuropsych the other day and he was talking about back in the day when case studies were written up on various therapies (often various kinds of psychoanalysis) and lots of times there were stories of total recovery of schizophrenia etc...and how you don't see that anymore.

6. Which of the following symptoms, if any, are you are experiencing? (Please choose at least one answer.)
( )Depressed mood (such as feelings of sadness or emptiness)
( )Reduced interest in activities that used to be enjoyed
( )Sleep disturbances (either not being able to sleep well or sleeping too much)
( )Loss of energy or the onset of fatigue
( )Difficulty concentrating, holding a conversation, paying attention, or making decisions
( )Thoughts of worthlessness or guilt
( )A considerable loss or gain of weight
( )Behavior that is agitated or slowed down
( )None of these apply
( )Unsure
7. How did you hear about this study?

This is part of the questionnaire from the site Faceyourdepression.com
1)This approach does not good indicate good therapy. there's no way therapy can be done online.
2)Therapy has lost it's way over the last 2 decades and there has been some psychologist treatment created that has nothing to do with real therapy.
3)The coach cliche is nothing but a cliche.
I don't understand what is going on in US.
I see no good psychologist approach. As I've already said "down here" we can find good psychoanalysts.
Some psychologists are also trying to make a good work but it's hard to find a good one.
I agree that psychiatry has also had a bad influence on psychologist treatments and I've heard that some psychologists want to prescribe.:o)
There's no way you can work both approachs with good outcome.
It's very rare to find good therapist and psychiatrist in one professional.
Therapy has nothing to do with advices or general thoughts about the patient's life.
Good Therapy is the work of two: therapist and patient.

The link you cited doesn't present any decent evidence that psychotherapy treats depression, though in fact therapy may be "at least as effective as meds in treating psychological ills" because meds are not effective. In spite of her pernicious ideas about biopsych, Sally Satel's "One Nation Under Therapy" is a great critique of therapy. The real solution is to simultaneously stop viewing human suffering as a medical disease, stop persecuting people who medicate emotional pain that they can't otherwise deal with, i.e. if you're stuck in a miserable job, it's better to smoke a joint than to blow your head off, but you probably want to stay away from these legal mood altering psych drugs that attempt to change mood without intoxicating because they change your perception too much. Anyway, back to the real solution, we also need to work on the underlying problems, altering the very structure of society.

Therapy is no substitute for real human connection and that's what's lacking for so many adults.

Therapism really is a dangerous trap, Satel (and even Torrey) just don't get that biopsych is at least as bad, but their work about the bad results from therapy seems valid to me. Yes, I'm getting my ideas from Szasz. If you think what Torrey and Szasz disagree about is interesting, look at what they agree about, hint - psychotherapy.

I've seen that add a million times on Philly TV. They don't run it on the NYC channels.

I also see constant ads during the daytime for various law firms advertising that "If a loved one died taking such and such a drug contact us".

I had to laugh, one of the law practices advertising like this was the late Johnny Cochran's.

Gee , for once in my life it's paid off to live right on the boarder between NY and Philly with the TV stations!

It's truly scary how drugs are used as the fix for all mental issues, as well as some physical issues, addictions and other problems. What's worse, the families and friends of patients, and the general public, buy into all the rhetoric, and pressure patients to use them. When patients stop using them, the family sees them as worse, which the mental illness may be, but they don't understand why the victim doesn't want to feel like a zombie, lose sexual pleasure, lose creativity, gain weight or not feel right in some way. It's truly frustrating.

Wow, finally the truth is told....I consider my psychitrist to be above average and 15 minutes would be an above average visit...

I wonder if this shift might also be attributed also to a gradual paradigm shift within psychiatry--away from the psychoanalytical paradigm (much more focused on a therapeutic model) towards the medical/brain chemistry paradigm (much more focused on a drug treatment model). While brain chemistry is clearly a developing field at best, it certainly is where psychiatry is headed...away from its Freudian roots, the couch, its wholly non-medical, non-scientific history. Therapy, then, is often left to the evergrowing number of licensed psychologists, psychotherapists, marriage and family therapists. Clearly, problems arise when insurance companies--wrongly, in my opinion--limit or even outright refuse coverage for this helpful therapy and only cover the medical coverage from the psychiatrist visits when these professionals could work in complementary ways for many people.

Too early to tell, I think. Once the screening is over, more information on who's funding the research will likely come out.

Talk therapy can offer a unique chance to have a safe relationship with a real human being who is both objective and compassionate. It's a mistake to throw out everything good about mental health professions when discarding the bad.

Sally makes some interesting points about psychotherapy. It is true that therapy can be highly destructive in the wrong hands. Diagnosing and labeling, which therapists often support, do as much harm in many cases as pyschopharmacology. Nevertheless the empathic alliance with a caring and supportive individual is often the key to healing in so called mood disorders. If a therapist is good at establishing this with the proper boundaries and helps a patient reframe their story he/she is worth their weight in gold.

I've definitely felt the same way about psychiatry replacing therapy. ]

I think CBT has proven itself. And, I think even healthy people can benefit from the mindfulness skills, self-soothing skills, and interpersonal effectiveness skills than dialectical behavioral therapy (DBT) offers. Also, Mindfulness Based Stress-Reduction (MBSR) therapy is showing a lot of promise. There's also a fusion of MSBR and CBT that I forget the name of that seems interesting.

I can shoot you an e-mail with some literature on mindfulness/meditation based therapies in terms of efficacy if you are interested. This stuff is being researched, and is showing a lot of promise, though it is perhaps not used.

The interesting thing about mindfulness therapy is that it aims not to squash or quell disturbing thoughts, but to train you to stop being disturbed by them. The thoughts eventually stop themselves.

I'm going to do mental health research in the hope that if I gain enough academic respectability, I can then do the kind of necessary activism and advocacy that you do here. They seem to like me well enough here at Vanderbilt. Keep your fingers crossed for me getting into graduate school here :)

Back in the '80s, the "therapy" I had was so miserable, invalidating, insulting and ignorant that I really saw the advantage of medication over that kind of waste of my time and abuse of financial means. I don't think ignoring the suffering of the patient is necessarily better than diagnosing the suffering in the violent and prejudicial way that often occurs. They are equally evil. I could have died from either format.

Psychotherapy = brain washing. By that, I mean that after every session, the therapist tells the patient "We are making progess" even though the sessions have gone nowhere. After hearing that "progress" is being made so many times, the patient will believe that they are getting better when in fact they are as ill as when the whole process was started. Ergo, brain washing.

I believe that every person understand therapy in a different way.
There has been so many kids of psychological treatments, psychoanalytic approaches that it's getting harder and harder for people to find out the help they really need.
The shift Melissa described has a lot to do with it.
I just want to say that therapy is everything but a person so "support you".
This is bad therapy.
There's no "salvation" in therapy.
One more time:
It's the work of TWO. If the patient is not working WITH the therapist we don't have good therapy.
Every case is a case.
It's true: therapy can do you harm. It can implant memories about your childhood and has other dangerous people working with brainwashing techniques and God knows what else!
But it works if well done and if the person really wants to go through this HARD work.
There's no easy way for therapy.
There's no quick fix...
After all some people has to come to term with a lifetime!

There's "love" on therapy. The kind of love Freud explained.
Or "hate" according to what Lacan believed.
I could never do it the Lacanian way.
I also want to remember for those who like scientific data that a Canadian University, i don't know which one, my mistake, made a research on talk therapy and drugs.
Talking therapy reached the Limbic system quicker than drugs and... with no side effects.
It tells me nothing.
But for some people these kind of data are important.
Unfortunately They didn't publish any statistics that I'm informed. But I'll try to find it.
:)

Yes, psychotherapy can be hard work. But usually when that statement is made when therapy is unsuccessful, there is the implication that the patient just didn't work hard enough to make it work. But what about the possibility that the psychotherapy modality was flawed to begin with.

Psychotherapy is very much still alive, but I think the couch is pretty much dead. Does anyone know anyone who gets therapy the old fashioned way, laying on the couch?

Tony, I would probably be saying the same thing you are if I hadn't run into the last therapist I ended up with.

The first one was a complete whack job. I've shared my story before, and in the interest of time I'll just say the 1st one lost his license. He liked to encourage patients/clients to bring stuffed animals to therapy and be childlike - a sick, sick person.

The second guy, my psychiatrist, was a whack job of a different sort. He has had multiple arrests & is a compulsive liar. He shares the name w/ a well respected researcher & pretended that he was that person. It's a really f'd up story, and I'll spare you the details. He, too, has ended up in front of his state board.

Needless to say, I didn't think much of mental health professionals after that point. I have paid a heavy price by being under their care & had to deal with a lot of rage. There are some seriously f'd up folks working in this profession. But, they're not all that way.

My therapist that I ended up with, the only sane one of the bunch, has quite literally walked with me through hell. When I first met her I was very close to putting a bullet in my head, I wasn't working, and even getting out of bed was a challenge for me. That is so far from where I am today. She built me up instead of doing what the previous two did which was rip me apart. She testified against my psychiatrist without being asked and without $ compensation - she did it because it was the right thing to do. She did not ever pathologize me. There ARE some good people in this field who do help. I am very grateful that I did eventually end up with a good one.

and i have an excellent DBT therapist....it's \not all about one 'disorder'.

Lisa,
I'm glad you found a good pro. I also had the fortune to find the right one. My therapy is over. After 20 years... I have tried two others but it was of any help.
I use to say that one of these is so bad that he can do you no good or evil.
"She did not ever pathologize me"
What'is in a name?
:)

I've found therapy to be a tremendous support. A particular antidepressant has worked consistently for me in the past 20 years in bringing me out of severe depression. It is like a switch being thrown. But a few times I have switched into hypo/mania and psychosis. Is it the med or is it me? Who knows. And Seroquel had a remarkable effect in quelling intrusive thoughts and anxiety that had be going on for years; this just in a couple of days.

But seeing my therapist over the last couple of years has made me realize that it's not all meds. A medication can't "cure" a bad day. But my thinking can help put it in perspective. I don't need to be chasing perceived symptoms with changes in dosage. Keep the med fixed and give things time. I believe therapy has given me a much more mature perspective on myself. And I don't believe a medication can do that on its own.

I've been on the psych ward since the end of June. With this, and the other 50 hospitalizations I have endured, the only talking therapy that occurred was between the patients (which has been very, very helpful). Both the nurses and the doctors are utterly uninterested in psychological treatment. That's a shame because my problem is psychological in nature and clearly not brain-based. Can't wait until I get out of this fucking place and off medication.

Francesca, you are probably better NOT having therapy in the psych hospital. My experience is that it's a joke. I had this social worker lead "group" who not only was a complete idiot but also seemed to think it was still the 1980's by the look of his attire. I remember during this one group he led one woman talked the entire time about how she just got a job working for MTV - the social worker just sat there with a blank stare & let her drone on and on about her delusion. The other group members were half asleep from their antipsychotics. It was a joke & I really think that it should be fraud to call that therapy & then bill the govt & insurance companies for it. It's ridiculous what they're allowed to pass off as treatment.

I've already told you about the group where they asked us, "If you were an animal in a circus what kind of animal would you be?" At that point I excused myself, went back to my room, climbed into bed and pulled the covers over my head. Seriously, it's probably a good thing they're not giving you "therapy."

Interesting you should bring this up, Francesca. I was out walking in the woods today, found myself reflecting on my 25-year experience with the mental "health" profession, including a tour of the nuthouses of North America that I didn't have in mind when I appeared in my high school yearbook.

I try and try to find something good about my experiences, but I try in vain. Even the really compassionate, concerned therapists (all three of them) I had, the ones who pulled me through the fires of hell, actually accomplished very little. Part of the problem is that almost ALL of our work together consisted of trying to repair the damage done by their colleagues. We succeeded only somewhat. I try to forget, but the assessments of all those folks with the "right" letters after their name continue to ring in my mind in times of stress (when I'd least like to hear them, of course).

In the end I look back on a quarter century of labels, demeaning diagnoses, incarceration, loss of privacy and dignity and--worst of all--nearly constant negative focus on the quality (or perceived lack thereof) of my every thought, emotion and behaviour. I know that the damage far outweighs any benefit. My self esteem has been damaged probably beyond repair and the original negative image of me given to me by my abusive family has been reinforced to a farethewell.

So yeah, I gotta agree, you may be luckier than you know. I realize this is small comfort in the scary situation in which you find yourself. It's not as if we check into these places because things are going so swimmingly in the first place.

After my first hospitalization (in a nice, middle-class, rather camp-like place where the food was good) I found out why the ONE thing you could do to get tossed out was to skip their lame and unhelpful group "therapy"--seems these folks were pulling down $45 a pop for this crap. This was in 1983, mind you. Let's do the math: Three groups, three times a week, each with 12-15 participants dozing off in their folding chairs. 3 groups X 12 members per group = 36 x 3 sessions per week = 108 billings per week X $45.00 per billing = $4860. Oooooohhhh. Now I see why group was soooooooo important. To the institution.

Jadedly yours,
Sherry

Sherry, you're exactly right the pressure to attend these groups is all about $$. They can't bill insurance or the govt for it if you're not attending the group - at least if you're in the chair they can pretend like they did something. They tried to tell me I would still have to pay for the groups even if I skipped them, and I told them I would check with Blue Cross to see if it's okay with them that they're billed for a service that I didn't receive. This led to more ugliness being written in my medical records, lol.

One of the staff members leading "group" was a woman who had previously been a nurse but got caught stealing narcotics from a hospital, was fired & was in trouble with the feds. She announced this to our group in her introduction. So, I'm sitting there thinking what makes her qualified to give me or anyone else there advice. They seem to scrape the bottom of the barrel when they hire people. I kept thinking what am I doing in this place. I'm depressed not a criminal (unlike my group leader). And yet, if you resist the groups because, for example, you don't really want to take advice from someone who has stolen drugs from a hospital - then they write you're non compliant with treatment in your medical record. If you're not crazy when you go in to a psych hospital, you'll be crazy by the time you leave.

I was never diagnosed with any mental illness and when I had life problems I found a therapist and it was always good. Problem was I never stayed long enough in therapy to address all the issues I needed to from a painful childhood. So in the midst of the med revolution -- and what I'll call the SSRI push in the late 90s -- I became vulnerable to the hard-sell of meds by GPs. My story, as well as so many others, is on PaxilProgress. For myself, I never would have been exposed to SSRIs if GPs weren't major shills and drug dealers for pharma. The problems I was experiencing at the time should have been addressed with therapy and a recommendation to go to al-anon (dealing with my then-teenage son's alcoholism). No, the answer was a hard-sell for Paxil. My life today is trying to pick up the pieces from having been on Paxil for over six years. The manic episodes that I experienced while on it destroyed my life financially, emotionally and spiritually. I look back now, after a two-year-plus horrendous withdrawal and I still have trouble understanding what happened to me.

I was basically a normal person with difficulties, but I worked, I was able to think, feel, be productive, I wasn't a danger to myself or others. Why did this happen? What I needed in my life at the time were solutions to real problems that had to do with the people in my life, not a drug to help help gloss over it, which is in effect what happened. Before the mania set in I started to become numb and simply addressed none of the problems, even as everything was spinning out of control around me. My doc's answer at checkups was you need the drug until the problems resolve and after I while I actually started to believe that all hell would break loose if I stopped taking the Paxil.

Now my life is a mess of constant deep depression and anxiety, OCD, agoraphobia and claustrophobia alternately, short-term memory problems, difficulty concentrating and a host of other things. This period of my life started with severe akathesia seven months after quitting Paxil. Today I feel traumatized and exhausted. My therapist, who I have been seeing for over a year now, is treating this as PTSD.

It is bad enough that mental illness treatment in this country is in such an atrocious state, although I question whether it ever has been very good or effective. The advent of the new psychotropic drugs into the general public, however, is now creating mental health problems. PaxilProgress gets over 3 million hits a month and has over 6,000 members now struggling to get off various SSRIs and putting their lives together after one of these drugs ripped them apart. Most of us are now dealing with real mental health issues we didn't have prior to the drugs and those that had problems prior, their problems are now much, much worse.

All I know is that just getting up and surviving each day is very difficult now. I will be in therapy for a long time to come. I have no insurance but luckily have access to a center at a teaching university and it's a sliding scale. I don't know what I would do without this. I have been helped here so much in the past. I'm hoping this time they can help save my life.

I do not understand why there are now so many people like me out there -- and it's all a result of pharmaceuticals which should never have been put out there for general use. We're in a real mess, and not just here in America, as a result of this -- and the body count of ruined lives is growing daily.

Anyway, I got off Paxil and obviously all hell did break loose, but I now know I was a goner from the moment I took that first pill and suffered a massive amount of physical side effects which my doc said, "Oh, that happens to a lot, it gets better." No, it doesn't -- it's just that the problems are longer physical, they're now serious mental-health issues -- and all caused by a legal drug. You're being changed in ways you never asked for and you don't even know it until it's too late.

Cathy - I was like this although I've improved since. I'm treating it like PTSD and I think much of it is but back when I was still doing pharmaceuticals I became convinced that many of the problems came from them. I hadn't had these problems before and I was in my late 30s when my therapy adventure started. Gosh I hope I don't have permanent brain harm from those pills.