A nurse once told me they were "the vitamins of the New Millennium." 'Cause, see, everyone takes 'em, and the stigma is much less and so no big deal....
We're talking here about psychopharmeceuticals, those miracle pills that have changed dramatically the psychotherapy field. Often, they are used as a therapeutic tool, as clinicians try to determine the proper diagnosis by trying different meds and different dosages. These are so fine tuned and so carefully dispensed that only the proper prescription will work with the proper diagnosis.
At least, that's what your med rep will say when he comes by with his satchel full of samples, free pens and notepads, and the sales pitch for the latest medication that will solve all yer ills, yessir, step right up, ladies and gentlemen!
Yes, much more can be done to help many more people with these little pills. People who formerly would have been condemned to a lifetime of emotional agony or hospitalization now can live lives that are as close to normal as anyone else. Rather than years of mental agony, people find some relief within weeks or even days.
So what's the problem? No, it is not that I don't have the training to prescribe when people come to me for help. I can refer them elsewhere for that if such is indicated.
The problem lies in two areas: the clinicians and the clients.
People are so used to pills that solve problems immediately, if not sooner. Got a headache? Take a pill. Got a stomach ache? Take a pill. Got anxiety? Take a pill. Got a relationship problem? Well, um, er..
Of course, not all pills, even these marvelous new ones, have instant results. The most common anti-depressants, for example, can take weeks to make noticeable differences. Yes, there are some pills that work quickly, but it can be hit-or-miss before the psychiatrist finds the one that works best for you. And once you have been taking most meds, it is not recommended that you stop on your own without checking with your doctor first. (There could be some rather unpleasant withdrawal effects.)
Of course, some people are not comfortable taking anything. They may still hark back to the early days when people on psycopharmaceuticals went about in a perpetual daze (not true anymore.) Or they be recovering addicts, and are wary of any pills, even aspirin. Or they resist medication for religious reasons, but come looking for some spiritual practice that will do just as well.
It is not all the fault of the client that the meds issue is often the topic in a first session. The clinician can be a little too eager to pull out the prescription pad after the initial fifteen-minute session. See me in another month or six weeks for another fifteen-minute session where most of the time is given to determining if this prescription is working or if it needs to be changed. See you again in two months. Oh, you want real therapy? Never mind the therapist who referred you; we have someone right in this office who will give you some time (brief therapy, six to ten sessions).
This way, you see, the clinician can schedule as many sessions per day as time permits. Never mind therapeutic alliance, much less empathy. The clinician may be quite good as a therapist and even a very nice person. But that is not the model chosen. Insurance companies have opted for a purely medical model, with the focus on the diagnosis and the treatment rather than the person.
Plus, you get quick and measurable results with medications. It's not as fast and obvious with traditional psychotherapy.
Oh well, sorry for getting so upset. Maybe I should just take a pill..
No comments:
Post a Comment