Richard A. Friedman in the NYT on a brain in a jar:
“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.
There is often no substitute for the self-understanding that comes with therapy. Sure, as a psychiatrist, I can quell a patient’s anxiety, improve mood and clear psychosis with the right medication. But there is no pill — and probably never will be — for any number of painful and disruptive emotional problems we are heir to, like narcissistic rage and paralyzing ambivalence, to name just two.
Anyone who doubts the need for psychotherapy research should consider the case of post-traumatic stress disorder, for which the mainstay of treatment has been exposure therapy.
This requires patients to re-experience the circumstances of their traumatic event, which is meant to desensitize them and teach them that their belief that they are in danger is no longer true.
But we know that many patients with PTSD do not respond to exposure, and many of them find the process emotionally upsetting or intolerable.
Dr. John C. Markowitz, a professor of clinical psychiatry at Columbia University, recently showed for the first time that PTSD is treatable with a psychotherapy that does not involve exposure. Dr. Markowitz and his colleagues randomly assigned a group of patients with PTSD to one of three treatments: prolonged exposure, relaxation therapy and interpersonal psychotherapy, which focuses on patients’ emotional responses to interpersonal relationships and helps them to solve problems and improve these relationships. His federally funded study, published in May’s American Journal of Psychiatry, reported that the response rate to interpersonal therapy (63 percent) was comparable to that of exposure therapy (47 percent).”
Read the article here.
There’s no pill for any number of painful problems? A lot of sci-fi can go straight to the garbage bin.
Back to the beneficial effects of self-understanding, it sounds almost like a severe case of nostalgia. And although I’m not a nostalgist, I’m in favor of self-knowledge, even if the self-knowledge causes unhappiness.