Posted by zeugma on September 21, 2006, at 8:23:40
In reply to Re: the brain » zeugma, posted by alexandra_k on September 20, 2006, at 21:08:08
(((alex)) mised ya too
> those value-laden adjectives spoil the analogy for meaw.
can you think of non value-laden replacements?well, first, I would like a broader definition of 'psychotherapy.'
I suppose 'psychotherapy' can be any intervention meant to promote psychological health. I suppose then that exercise, dietary regimes, etc., can be considered 'psychotherapeutic' if applied with the intention, specifically, of promoting this end.
Psychotherapy in the narrower sense is something I have a lot of problems with. An idea promulgated from therapist to patient, or attitude promulgated, can have far more toxic long-term effects than clumsy pharmaceutical interventions. I am convinced that excessive exposure to psychotherapy significantly worsened my conditions (which far predated psychotherapy, so I am not saying my illnesses are iatrogenic. Still, they were worsened, iatrogenically, and the doctors in this case were all psychotherapists). I don't believe that I can generalize from this, however.
As regards biobiobio vs. biophysicalsocial, social interventions can change a person's biology, but only if the disposition is there already. There is probably a 'top-down' vs. 'bottom-up' distinction. A social intervention makes use of 'top-down' mechanisms, but, (I am making use of an account of psychotherapy in Joseph LeDoux' "Synaptic Self") this is dependent on the integrity of the corticolimbic pathways (there's some biobabble). If those pathways are broken down, then (and LeDoux doesn't say this, but I am extrapolating from his account) maladaptive pressure is being applied to a particularly damaged circuit, which results in the functional, and possibly physical, equivalent of crude psychosurgery.
Psychotherapy, in the broad sense, appears to be one of those fields where 'delicate' and 'crude' are not distributed evenly. Gross physical or behavioral damage is easy enough to point to, but since the fundamental pathology of virtually all CNS disorders (or conversely, the mechanisms of its proper functioning) are mostly unknown, the only truly 'delicate' intervention is a placebo, because of the economy of means relative to behavioral effect.
I once posted the results of a head-to-head trial pf placebos, in which one was significantly better than the other. Maybe the more efficacious placebo qualifies as delicate psychosurgery.
-z
poster:zeugma
thread:686603
URL: http://www.dr-bob.org/babble/20060919/msgs/687856.html