From: dave@bradley.bradley.edu (David Vessell)
Subject: Re: Partial Legalization
Organization: Bradley University
Distribution: usa
Date: Sun, 26 Jul 92 07:38:14 GMT

lamontg@milton.u.washington.edu (Lamont Granquist) writes:

>pwh@bradley.bradley.edu (Pete Hartman) writes:
>
>>lamontg@milton.u.washington.edu (Lamont Granquist) writes:
>>>
>>>What these people need is adequate pharmacotherapy to fix the underlying
>>>biochemical problem without all the psychological "you can do it yourself"
>>>bullshit.
>>
>>I think you also might not be aware (Dave didn't explain it very well)
>>that he was on medicines to help him gain the stability he needed
>>while he transferred whatever mental cure he has achieved into
>>reality.  He didn't have some magical enlightenment whereby he tapped
>>the power of his subconscious and miraculously was cured--he had some
>>drugs and some therapy to help him through the beginning stages of
>>the problem, and has since been able to abandon most (or all?) of the
>>drugs in favor of a more internalized long-term cure.
>
>That is *ONE* example.  And I will agree that in Dave's case, it may have
>been more appropriate to have pharmacotherapy play a supportive role in
>just facilitating the eventual effectiveness of psychotherapy.

One example among an overwhelming number of identical and similar cases.
You don't have to dig too deeply to find that most studies show
psychotherapy backed up by drug therapy is the most effective treatment
with the lowest relapse rates.


>However, on the other side of the coin, I can see other cases, where
>pharmacotherapy would need to be used as the primary cure.  And
>psychotherapy would be used in a supportive role -- to eliminate remaining
>neuroses and personality problems and to assure that the person did not
>become dependent upon the pharmacotherapy.  But with the pharmacotherapy
>being the primary "cure" for the mental disorder.  In that case, "you
>can do it yourself" messages really would be bullshit, since they'd
>need pharmacological help.

The reason I put psychological approaches above physiological approaches is
this:  If you approach every mental illness with drugs first, that's a lot
of money towards drugs.  If the drugs are effective, there's a good chance
the drugs will be given on a long-term basis, which is a huge waste of
money if the person could have used a talk therapy to become
self-sufficient sooner.  However, if you take the psychological approach
first, then even if it turns out to be less effective than necessary,
you've already laid the psychological groundwork which may actually reduce
the amount of drugs needed to achieve the desired level of adjustedness.

Of course, the attitude of the therapist is important as well.  Either
approach can give a patient bad vibes about himself, adding more problems.
As you have already said numerous times, using a talk therapy first that
doesn't work might give the patient the message that they're too mentally
weak to do anything for themselves.  On the other hand, going straight to
drug therapy gives the patient the idea that they're 'damaged goods' and
that they have no hope of leading a normal life without drugs, which of
course isn't true.  Treating drug addicts in that manner would be even more
tricky, because you're basically telling him, "Well, you can either
continue to be addicted to cocaine, or you can take Potrzebie for the rest
of your life, which will keep you off the cocaine unless you stop taking
it."  By going with drug therapy first you preclude the possibility of the
person helping themselves.  While drug therapy may be helpful for many
people, *everyone* can benefit from talk therapies in one way or another.
Even in strongly biochemically-induced conditions since a person's attitude
towards his biochemical situation will inevitably affect how much the
person benefits from the drugs.

I must admit to being less than objective, as my own circumstances no doubt
colour my opinions on this subject, but the numbers are there to back up my
opinions, and I stand by them.

>
>My whole point is there is a spectrum.  And that psychotherapy is no more
>important than pharmacotherapy and that blanket statements about addiction
>that only address psychology are utterly ignorant without also addressing
>the biochemical mind to an equal extent.  What really concerns me is that
>most of our focus on rehabilitation is entirely psychological and I think
>that they've entirely missed the boat...
-- 
=========*davE*.....making the world safe for intelligent dance music.=========
               Andre Marrou -- Libertarian for President 1992
--(David Vessell)--(Bradley University Computing Services)-(dave@bradley.edu)--
Newsgroups: talk.politics.drugs,alt.drugs