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Re: Larry, your take on CBT? » Squiggles

Posted by mattdds on May 30, 2003, at 21:39:02

In reply to Re: Larry, your take on CBT? » Larry Hoover, posted by Squiggles on May 30, 2003, at 19:53:21

>>Well, what with the emphasis on nutrition,
magnesium, and Cognitive Behaviour Therapy,
i wonder if you are not infact anti-psychiatric
drug treatment

Whoa! What on earth are you talking about?

I will let Larry speak for himself, but since when does recognizing that there are other things that work for mental illness besides drugs mean you are "anti-psychiatry"?

Even the most hardcore pharmacologically oriented pdocs will admit that CBT, sound nutrition and a sound philosophical outlook on life will contribute to wellness. Even the American Psychiatric Association has published studies showing that CBT is equally effective as drugs in many disorders such as panic, anxiety and depression. I am not just making this stuff up, it is quickly becoming the standard of care!

I do CBT, *and* take Klonopin, for example. The two approaches (meds and therapy) are not at all mutually exclusive, but are rather extremely synergistic. You see, CBT, meds, and likely supplements are all just different avenues to change the way you feel.

I too feel that the current mental health system has some serious flaws. HMO's would never pay for terrific, evidence-based treatments like CBT because it would simply cost too much, so it's the assembly line approach. Also I believe that the pharmaceutical companies, with their strongly vested financial interests are exerting way too much influence on how psychiatrists are trained. So we are stuck with getting an extremely impersonal "what are your symptoms" ----> "here take this drug" ---->" now get the hell out so I can pay my overhead" approach.

Does this mean I'm "anti-med"? I guess I am anti-**only med**. But meds have saved my rear in more than one situation. They are one extremely important component of my recovery. But I feel without CBT, my response to the meds would not be anywhere near as robust. For example I tried benzos before CBT for panic disorder, and they did not do much. After CBT, I feel close to 100% better most of the time. For me, they very much had a synergistic effect.

It is not good to hold on to ideas or beliefs too tightly. I am as guilty of this as anyone, but I'm learning. But it seems that some people have an almost religious belief in psychopharmacology as the only method that works. We've really bought into the monoamine hypothesis to the point that we don't consider anything else! I'm all for *anything* reasonably safe that will work. I am not Peter Breggin. I just think that the only meds approach in psychiatry is akin to treating hypertension with only drugs, and ignoring the fact that you are prescribing them to an overtly obese chain-smoking couch potato. This approach does not fly for most good internists, so why do psychiatrists do it? To ignore all these other factors, in my mind is nothing short of negligence.

Best,

Matt


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