{"id":58489,"date":"2015-07-22T21:54:31","date_gmt":"2015-07-23T01:54:31","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=58489"},"modified":"2015-07-22T22:19:43","modified_gmt":"2015-07-23T02:19:43","slug":"still-around","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2015\/07\/22\/still-around\/","title":{"rendered":"still around…"},"content":{"rendered":"
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Psychiatry’s Identity Crisis<\/a><\/div>\n
New York Times<\/font><\/strong><\/div>\n
by Richard A. Friedman<\/div>\n
Contributing Op-Ed Writer<\/div>\n
July 17, 2015<\/div>\n

AMERICAN psychiatry is facing a quandary: Despite a vast investment in basic neuroscience research and its rich intellectual promise, we have little to show for it on the treatment front. With few exceptions, every major class of current psychotropic drugs — antidepressants, antipsychotics, anti-anxiety medications — basically targets the same receptors and neurotransmitters in the brain as did their precursors, which were developed in the 1950s and 1960s. Sure, the newer drugs are generally safer and more tolerable than the older ones, but they are no more effective…<\/p>\n

At the same time, judging from research funding priorities, it seems that leaders in my field are turning their backs on psychotherapy and psychotherapy research. In 2015, 10 percent of the overall National Institute of Mental Health research funding has been allocated to clinical trials research, of which slightly more than half — a mere 5.4 percent of the whole research allotment — goes to psychotherapy clinical trials research.<\/p>\n

As a psychiatrist and psychopharmacologist who loves neuroscience, I find this trend very disturbing. First, psychotherapy has been shown in scores of well-controlled clinical trials to be as effective as psychotropic medication for very common psychiatric illnesses like major depression and anxiety disorders; second, a majority of Americans clearly prefer psychotherapy to taking medication…<\/p>\n

Finally, many of our patients have histories of trauma, sexual abuse, the stress of poverty or deprivation. There is obviously no quick biological fix for these complex problems. Still, there has been a steady decline in the number of Americans receiving psychotherapy along with a concomitant increase in the use of psychotropic medication in those who are treated in the outpatient setting. These trends are most likely driven by many factors, including cost and the limited availability that most Americans have to mental health practitioners. It is clearly cheaper and faster to give a pill than deliver psychotherapy…<\/p>\n

More fundamentally, the fact that all feelings, thoughts and behavior require brain activity to happen does not mean that the only or best way to change — or understand — them is with medicine. We know, for instance, that not all psychiatric disorders can be adequately treated with biological therapy. Personality disorders, like borderline and narcissistic personality disorders, which are common and can cause impairment and suffering comparable to that of severe depression, are generally poorly responsive to psychotropic drugs, but are very treatable with various types of psychotherapy…<\/div>\n<\/blockquote>\n
A couple of months ago, I had me something of a rant. It was long overdue for me:<\/div>\n