What disturbs me most about the trend towards ‘medication first/medication exclusively’ is not the notion of medication itself. If a pill could cure problems as well as the medical establishment would have us believe, then life would be an effortless picnic.
However, psychiatric pills don’t cure everything. In many cases, they cure nothing and only serve to build false hopes in people looking for a quick or impossible solution to their personal troubles. I know this from years of working with people for whom medication was not enough of a solution, or, more often, not a solution at all.
In this era of increasingly regulated government health care, some insurance companies and government programs do their best to funnel people with even the slightest bit of emotional angst to a medical psychiatrist (or better yet, a swamped primary care Medicare/Medicaid doctor) for medication. They hope a quick fix will save the government money. However, it doesn’t work out this way.
Psychotherapy represents the alternative to this rush to medication. Psychotherapists are non-medical mental health professionals who practice using techniques of therapy and counseling. (See my recently published book: Bad Therapy, Good Therapy: And How to Tell the Difference for extensive details.)
Despite the proliferation of psychiatric medications on the market, therapists’ offices are flooded with patients. I sometimes have two- or three-week waits for new patients and I’m hearing the same from colleagues throughout the country. Therapists who are willing to accept third-party payments (government or insurance) have packed offices all the time. What does this say about the effectiveness of psychiatric medication for the great majority of people suffering from emotional anguish?
No cure for maladies that ignores important aspects of human behavior, medical or otherwise, can ever be effective. Here are some aspects of human behavior that the proponents of medication for psychological and emotional conflict typically ignore.
Wrong choices people make
Examples: Spending or drinking to excess; treating significant others in your life poorly; remaining friends with people who are bad influences on you; engaging in too much or too little delaying of gratification.
No pill can undo the damage of wrong choices. The unhappy emotions you feel—depression, anxiety—are natural and even logical responses to your having made wrong choices over a period of time. Go to a mental health professional, if you like, to talk about why you make these wrong choices and (much more importantly) how you can reverse course. Don’t ask a mental health professional to say, do or prescribe something to make you not feel the inevitable emotions which arise from making wrong choices. It won’t work. Even if it could work, it would do so at the expense of shutting down your consciousness to some extent.
If your consciousness is numbed or shut down, then how can you take charge of your life and use your mind to think and make better choices?
Right choices people fail to make
Examples: Failing to plan a new career despite knowing, for years, that you hate the one you’re in; refusing to do anything about your faltering marriage/ relationship even though your spouse/partner is increasingly unhappy and you know it; failing to get caught up on your ‘to do’ list and then being overwhelmed with too much to do.
Once again, drugs cannot and should not shield you from the inevitable emotional consequences of wrong choices. The unpleasant emotions you feel from failing to make good choices are actually your allies, because they tell you that a course correction is required. Without these allies, you might never feel the motivation to make the changes you need to make. Taking pills to numb these feelings can only delay or maybe even suffocate desirable, positive change.
Here are some other examples of premises (both true and false) that many people typically hold:
Human beings are by nature untrustworthy;
Men are by nature abusive;
Women are by nature hysterical;
Life is a vale of tears and then you die;
Life is an exciting adventure where solutions are usually possible, and even when solutions are impossible, negatives can be turned into positives;
The mind (including my own mind) is inherently rational and can solve problems;
The mind (including my own mind) is inherently irrational and weak and can’t figure out things well.
The philosopher/novelist Ayn Rand (who wrote Atlas Shrugged and The Fountainhead) used to have an expression: ‘Check your premises.’ From a psychological as well as philosophical perspective, she was absolutely right. If your premises are wrong, or they conflict with other aspects of your thinking, then you will experience psychological conflict.
Psychiatrists take note: No pill can check and correct your premises for you.
(Continued in tomorrow’s column.)