Posted by floatingbridge on August 17, 2011, at 8:22:54
In reply to Re: Compelled to quote.... » hyperfocus, posted by SLS on August 17, 2011, at 7:01:32
Well, I don't understand the fine point of the complaints with this essay, though I must be missing something. I didn't feel medication was being given the back seat to therapy but rather our scientific assumptions of exactly how those medicines work was tentative,
Here's the abstract again:
The assumption that the etiologies of DSM-IV disorders are
fundamentally related to chemical imbalances is challenged.
While the chemical imbalance model may eventually be empirically shown to be unequivocally accurate in specific
disorders, this is not presently the case for any disorder. The
attempt to correct chemical imbalances through medication is
at the heart of modern psychiatric treatment, as are evidence-
based protocols which follow from the establishment of an
accurate diagnosis. * There is much to be said for this
approach, but the downside is that other medication treatment
strategies are rendered illegitimate.* Instead of correcting
imbalances, it is argued that *pharmacological agents may be viewed as inducing particular psychological states which
though not specifically related to diagnosis, are nonetheless the basis for the usefulness of the medication.* This
perspective provides justification for using medications in
clinical situations that may not even be DSM-IV defined. To
properly use medications in this way, patients must more often be viewed in the complexity usually associated with psychotherapy. A case is made against the widespread use
of medications by non-psychiatrists as well as the 15-minute,
once-a-month medication visits that have become standard psychiatric practice, both the product of the chemical imbalance model.I read this as supporting the use of medications the way many babblers do. In off-label ways to induce or count-
induced *psychological states* of well being. We really do not understand the chemical shortage or imbalance model all that
well, though talk as if this model were a truth accepted.
*there is much to be said for this approach, but the downside
is that other treatment strategies are rendered illegitimate*.How many of us use medication successfully off-label?
Further, the induction of a (helpful) psychological state with off label usage has it's best chance of being done in a more therapeutic alliance that the 15 min check in.
So read *inducing a physcological state* vs *the chemical imbalance theory*. The first sound less scientific and takes
more observation on the author's part than the 15 min dsm consult.I do not see the author replacing medication with therapy; rather widening the view in which and how we prescribe.
Again I see what I quoted a few posts up that the chemical imbalance model is more comfortable dispensing what are seen as 'missing chemicals' rather than inducing a psychological state for it's own state which might be viewed more like 'drugging' a patient. Read this way, is the author against the amelioration of real suffering or does he seek to widen application, done so with the care and observation that spending more than 15 minutes with a client can?
You all can give me a reality check here.
Thanks.
I dig a pony.
poster:floatingbridge
thread:992265
URL: http://www.dr-bob.org/babble/20110809/msgs/994088.html