Posted by yxibow on August 28, 2006, at 16:16:07
In reply to Re: Biopsychosocial vs Biological Reductionism, posted by Estella on August 28, 2006, at 2:55:38
> > It might be that for a long time yet... Maybe even forever as a matter of principle (ie not just due to the current state of our knowledge) the best way to treat mental illness is to...
>
> > Talk to people.
>
> Sorry. I should have been clearer. I meant for the disorders at which the psychological level provides the most robust generalisations. Actually... I don't know whether the level of explanation implies anything for the level of treatment or not. But anyhoo...
>
> (I'm not really opposed to meds. I guess I just wanted to make that clear. I guess I just think it is a shame - and it probably misguided to think that medication is the only or best treatment)
Medication is never the only treatment in a proper program for psychiatric disorders, regardless that all have fundamental and impermeable underpinnings in brain function or brain differences which cause neurochemical imbalances that can be treated to whatever 2006 has in its medication arsenal.A true program always integrates psychodynamic, behavioural, and other forms of psychological therapy adjunctive to medication, the medication which makes life livable enough to deal with the psychological and perhaps even environmental factors that triggered a brain chemical disorder.
We have evidence dating back now at least 15-20 years of things like PET studies showing a "control" and a person with fairly strong OCD, giving each say, a dirty towel or something that sets off the psychological factor which then sets of the biological and neuronal level changes in the caudate nucleus. The differences are dramatic. Such studies also show the similarities and differences of a followup study of someone treated with medication, someone treated with behavioural therapy, someone treated with both, someone treated with control, and these are very visible. I happened to work for someone in that key field so I saw these scans, they were quite demonstrable. And such work has continued with more modern equipment on other conditions.
So I know I have a lifetime imbalance that will change over time and hopefully shift for the better during those periods. But that doesn't mean I may also not be of need of psychological adjunctive therapy which I recognize and that is the part I agree with.
It's just a shame that the current HMO 15 minutes once or twice a month and write a prescription is the current model. Its also the current model of most GP services for a once a year 15 minute physical how-are-you-doing, let me examine you, thanks, especially in large cities. The days of the doctor with the bag who came to your house are largely gone except for subsidized programs for shutins, seniors, etc.
-- Jay.
poster:yxibow
thread:680731
URL: http://www.dr-bob.org/babble/20060825/msgs/680894.html