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atuttle's picture

Do any of these options work for everyone?

Sorry for the late response! I want to reflect on what I've read in the forum this past week, and offer up a question. It seems that many of us are struggling to find the "better" of the two options available to people with different types of mental illness: Either talk therapy or drug remediation. And while many point out that there is evidence that neither therapy works in every case, the majority of responses I have read appear to be making a value judgment about these remedial options. My question is, can we reach an overall conclusion about what therapy is more "natural," more "comprehensive" or "better" without looking at conditions on a case-by-case basis?

Without repeating other people's points, Dr. Yarin conceeded that CBT does not work for everyone. Additionally, as I pointed out in class last week, talk therapy is in many ways more of an art than a science; like perscribing medication, a clinician must be sensitive to a patient's individual differences. The quality and nature of the therapeutic dyad can have far-reaching and tangible differences in a patient's improvement.

And yet, we are more than the sum of our parts. Throwing a few more neurotransmitters into our "bag of chemicals" (i.e., our brain) do not appear to offer long-term benefits. Additionally, the biopsychosocial model predicts that even when we artifically control for the biological substrates of behavior, additional variables from our past experiences and current environment can throw this delicate balance out of whack. Clinical evidence seems to support this model: The longest-lasting therapeutic benefits appear to be a combination of different techniques. That being said, different people require different approaches. To summarily praise one type of therapy over another, I believe, is premature at this point in time. Due to the complexity of our mental experience, I believe a "cureall" or "silver bullet" for mental illness is impossible. Rather, therapy must be based on the individual's specific needs.


~Alex Tuttle

Haverford '08


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