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Amelia's picture

Talk Therapy vs. Medicinal Therapy for different individuals

I have to agree with what Jenna is saying, in that I don’t see people who choose to take medicine instead of going to therapy as coping out or failing. I think the success of talk-therapy is based on who chooses to go to therapy. People who don’t want to go to therapy, for whatever reason, would probably not have as positive results as people who are motivated to go each week and do the homework they are assigned with CBT. Also, the success probably relies on the ‘disorder’ that it is treating and its nature. PTSD’s nature is one that would benefit more from talk therapy, while I don’t see that bipolar individuals would be able to do such therapy without a medical intervention first. You can see drastic differences in bipolar individuals when they are either on or off medication.

In addition, as many people have brought up, therapy and drug treatments work better together than either by themselves. With bipolar individuals who I would say ‘need’ medication, they may be able to function even better if they combine this treatment with talk-therapy. While what we talked about in class is how the two work similarly on the brain, I think this points to the fact that there is something different going on with drug and talk treatments. Maybe the end result on the brain is the same, but different pathways seem to be affected. When you’re adapting two brain pathways (in very general terms) instead of just one, you’re going to see better results. If it were the same pathways I don’t think you’d see the large increase in how many people are helped with combining the two. Someone said that they must be working on different systems because medications have different side effects—while I think different systems are affective, this doesn’t work as a reasoning since medicines we take are never specific enough to work on just one particular aspect (as we talked about in class with Dr. Yadin).

One reason that I see people as skeptical of psychotherapy is the point I brought up in class, that you can’t do the animal model testing of therapy, or even on humans, to really see changes on the chemical level of the brain. I for one find fMRI imaging as somewhat questionable as to what conclusions we can draw from this. We do see differences before or after therapy, but when you think about the size of the voxels and the slight change in ‘color’, it doesn’t seem reliable. Maybe therapy changes something else in the system so that brain areas change their activation. This doesn’t mean that I think psychotherapy isn’t valid. I think it is, but it depends on the disorder and who chooses to go into therapy. If someone is not convinced about the therapy working, they are probably more likely to have the therapy not work. If there was some way to assess the chemical signaling in humans who receive therapy (instead of just brain scans) more people would see therapy as valid. In the end, it will work for some people and not for others, as with any treatment.

Another reason people are skeptical, which I’ve touched on slightly, is that we as a society are used to the biomedical model of disease and not the biopsychosocial model which is more ‘true’ to what diseases and disorders are. Until we as a society are able to get beyond the biomedical model, people are going to be skeptical of treatments that aren’t medications that can quickly ‘fix’ us. Hopefully, as people learn more about the mechanisms by which psychotherapy is working, people will become more accepting of it.



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