24 June 2007

The value of psychotherapy

Partly because I think that Freud was a quack and the psychiatric sciences are in roughly the same stage of development as medical science was around 1688, I have never had much trust in psychotherapy. So it was nice to see my prejudices confirmed in an article in Newsweek I was flipping through at the library where Carmen works. It was talking about post traumatic stress syndrome and what is called 'stress debriefing' where the patient examines the incident causing trauma in detail and relives it in order to get it out of their system.

Many of those who undergo stress debriefing develop worse PTSD symptoms than those who deal with the trauma on their own, controlled studies show, probably because the intense reliving of the trauma impedes natural recovery. Burn victims who underwent debriefing, for instance, had worse PTSD thirteen months later than victims who had no psychotherapy; people who went through it after a car crash had greater anxiety about travel three years later than those who did not.

"probably because the intense reliving of the trauma impedes natural recovery" - I would have thought common sense might have told us that. It reminds me of a friend of mine who grew up in Tallahassee and suffered greatly as a child because his mother had gotten the idea in her head that the best cure for sunburn was to apply something hot. So when he came home red and tender from too much time outdoors, she would stick him in a tub full of hot water and apply hot water bottles to him at night.

At least her treatment was free.


At 25 June, 2007 16:27, Anonymous ellen samuels said...

that article was flawed in so many ways. It didn't explain the differences between practioners, it confused psychiatrists (MD's with 4 more years of training in psychiatry) from psychologists (doctorates in psychology) from people with counselling degrees that take mere months etc. There are states where anyone can hang out a shingle and be a 'therapist'
There are a lot of bad and unqualified therapists out there.

That said, for traumatic situations that just occured there is good research to suggest beta blockers take away the memory and symtoms if taken quickly.
Proper therapy/cognitive work can lessen symptoms greatly. Poor treatment by unskilled or improperly trained people can do a lot of damage!
Would you go to your auto mechanic for heart surgery if he had a certificate in 'cardiac parts'? or the state he worked in allowed anyone to hang a shingle out saying 'cardiac surgeon'?

It's basically the same thing- but people think because it has to do with the 'mind' it's different because mental issues are not 'real' or totally under a person's control if they are strong enough.

Pay attention to the credentials of who you go to!

At 26 June, 2007 16:44, Blogger Clemens said...

Thanks for the input Ellen.

The article may sweep with too broad a brush, granted. It may also be sloppy with its terminology. But its point was that what is called here 'psycotherapy' doesn't seem to be doing too good a job.

Pointing out that some therapists are unqualified and beta blockers might help only reinforces that as far as I can see. And we are talking about a therapy, not the practitioners.

And if there are so many unqualified therapists out there, what should be done about it, and by who?

The point of the article, I thought, was that indeed there are 'real' problems to be dealt with, by 'real', as in effective, means. I posted it because I don't think we know anywhere near enough about psychiatric science to say much, unfortunately.


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