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Elliot Rabinowitz's picture

more on psychotherapy...

To bounce off of Liz’s last point, I did not really think about the side effects of psychotherapy as compared to drug therapy. Side effects from exogenous substances put into one’s body seem to be expected for just about any drug taken for any “disorder”. I would imagine that psychotherapy also probably generates some side effects in a number of individuals. Whether these side effects are exactly the same as those seen in individuals on medication, I am not sure (but would certainly like to know). However, I also guess that there may be fewer side effects, simply for the reason that although psychotherapy may lead to similar outcomes as drug therapy, it works in a different way. Psychotherapy, at least CBT, seems focused on individual drive and perseverance. As stated in a number of the people’s posts above, taking drugs is a lot easier. However, drugs are then an external force on the body’s system. Working through CBT seems more natural. From what Dr. Yadin said, it truly sounds like a progression of working with the patient through multiple steps. This step-wise process, though intense, seems more conducive to minimizing secondary effects as compared to a drug shocking one’s body. However, I am just thinking about this theoretically without any real data on which to base my hypothesis, so anyone else’s ideas would be more than welcomed.

 

Something else that Dr. Yadin brought up that I found particularly intriguing was the idea of separating oneself from one’s disorder, whatever it may be. She described it as a relationship between a person and their disorder. This relationship can change over time and one’s feelings towards it can vary. I cannot say that I have personally felt this relationship, but I can imagine that this description would be true. We somewhat touched on the idea of depression as advantageous in different settings and at different times, but also often more negative in other situations. Maybe this leads people to accept and reject their depression depending on the situation (even if it is often viewed as something unwanted). As to what this all means for psychotherapy, I could also imagine that different therapeutic techniques may not only work better for different people, but also for specific people at different times in their life depending on their relationship with their disorder. We also touched on this idea when discussing how people sometimes need a refresher course in CBT to avoid relapse. I wonder if taking drugs to treat relapses works more effectively in individuals who have undergone CBT at an earlier point in their life. Or maybe they don’t do any better, and CBT is usually more effective in such cases.

 

All of this seems to relate back to what Emily posted – the importance of individual differences. People need to be thought of in relation to the environment in which they live, the relationship they have with their “disorder,” the hopes they have for therapeutic results, the seriousness of their physical and mental states, their cultural beliefs, etc. Even though our fundamental biological systems are so genetically and physically similar, it is still important to remember all of the things that make us different.

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