April 4, 2010

What if? (A post by Jung At Heart)

Something about a recent post at Jung At Heart really resonated with me. In my work, I struggle with working within the medical model, and with the DSM-IV, etc. While our work is based in research and theory, there is something more to is that keeps it separate. At least in my opinion. Anyways, here is the post, and a small excerpt from it that I liked:

What if? @ Jung At Heart
I wonder what would happen if someone presented at a conference suggesting that psychotherapy should not be in the medical model at all? That maybe psychotherapy belongs in a wholly different category, somewhere in the neighborhood of education, spiritual development, and personal growth? What if we stopped trying to prove scientifically that the relationship in therapy is healing? What if we gave credence to self-report by patients that therapy had helped them? What if we stopped considering problems in living, which is what most people coming for therapy are struggling with, as illnesses? What if we considered treatment of major depression and other problems responsive to psychotropic medications as belonging to one field and psychotherapy to another one altogether? What if?



jacqueline said...

what if? a few things, in brief... with reduced stigma, more people might be willing to give "psychotherapy" (the very name suggests illness) a try. if you, for instance, went to a therapist who viewed you as having resolvable issues in living successfully rather than as mentally ill, it would undoubtedly change your relationship with that person, and that in turn would likely influence outcomes from time spent together.

on the other hand, if psychotherapy were not categorized within the medical model, medical insurance surely would not pay for it (making psychotherapy a luxury item available only to those who could afford to pay for it themselves), which would in turn jeopardize certain services currently available to the poor under medicaid.

making a distinction between treatments that respond to psychotherapy and those that do not is a very sticky proposition. antidepressants work for some people but not for others. where to draw the line, for instance, between depression and unresolved historical grief? or for that matter, depression and the despair that arises from poverty? even antipsychotics only work for some people, but virtually everyone who takes those drugs has experienced trauma of some type, even if only the identity shift and multiple losses associated with a label and membership in the mental health system.

having said all that, I also struggle with working within the medical model and our broken mental health system. I'd love to see more brainstorming discussion here about how to align psychotherapy and what's currently known as "mental health" services under a different and more humane category.

Anonymous said...

I had similar thoughts when I studied Psychology as an undergraduate, and the “scientific” emphasis, the need to study Statistics and write “evidence-based” research papers, the medicalization of some states of mind I consider normal reactions to extreme adversity, were some of the reasons I didn’t go to graduate school. Having said that, I live a double life, because I cannot afford to spend $100+/week on therapy so I am using my medical insurance when I feel the need for that. How much would a therapist need to earn in order to make a living if they worked outside the medical world, what income would they consider acceptable, and would this bring therapy’s cost down and available to more people? Between the cost of renting an office and buying health insurance for them, at least in the US, maybe it wouldn’t be feasible. Is the medical model an outcome of today's theories about human beings, an economic choice, or both?


antiSWer said...

Interesting ideas. I think it's important that there's no good answer. Would taking psychotherapy out of the medical model solve anything? Maybe some things, but it might also create some more problems. Sigh...too big an idea for me to think about after THAT paper, but great ideas, peeps. I like the discussion.

Anonymous said...

i kinda love your blog! i just gt my msw and work with clients and do an awesome job but have days where i'm over it! i'd rather be a superhero and be in my batcave at times lol. i hope you post more; don't stop!

Whereapy said...

Interesting - as a massage therapist I see mental health as being so totally connected physically, mentally, socially and spiritually.

I wonder if you've seen the Jeremy Rifkin lecture that RSA Animate made -- The Empathic Civilization? I think it is similar in feeling/tone to what your are saying here.


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