Dr. David Raque

© Susan Todd-Raque

When I entered graduate school in 1968 to study psychology the growing debate was about whether talk therapy, also known as psychotherapy, was effective. Of course, at that time the field of psychiatry was limited to only a few medications to treat depression, anxiety, and psychotic disorders, with many of these medications having uncomfortable side effects or not being effective at all.

During the 1960’s and 1970’s psychiatrists, like psychologists and clinical social workers were engaging in the most effective treatment of psychotherapy, talk therapy, to help people with their depression and/or anxiety. There were many different schools of theory and technique as to how to effect the best change.  Due to the bad side effects, medicines were usually reserved to treat those people who were severely depressed, severely anxious or with people who suffered from psychotic disorders. As many of you may know, ECT (electroconvulsive therapy) was also used to treat refractory depression and some cases of psychosis.  Another approach was publicized in the movie A Beautiful Mind starring Russell Crowe, a true story about Dr. John Nash, a Noble Laureate in Economics.  Dr. Nash suffered from paranoid schizophrenia. In this movie, because of the painful, frightening delusions John Nash experienced, he was put on a medication called Thorazine, at the time the best antipsychotic available but often with devastating neurological side effects.

In 1987 Prozac came on the market as the first of a long line of antidepressants. Since then, SSRI’s or SNRI’s have flooded the market. All you have to do is watch TV at certain times of the day when the pharmaceutical commercials flood the television with their advertising the “drug cure of the moment”.

Initially, the general consensus was these medications were so effective the pharmaceutical companies began dispersing them to family practitioners to give to many patients complaining of the symptoms of depression, without being fully evaluated by a mental health professional.  Referrals to psychiatrists went up dramatically as everyone who was depressed, anxious or thought they had OCD wanted to take a pill to eliminate their symptoms.  As expected, psychiatry has become a medical specialty that targets mental health issues by identifying symptoms and then prescribing medication. Like other medical specialists who treat specific physical symptoms, psychiatrists spend their time with patients mostly identifying the patient’s psychological symptoms and then recommend a medication. They spend much less time with patients talking about their background, psychodynamics or current stressors.

While I do know there are many conditions where medications are the medically prudent and right direction to go, it is my biased opinion we have forgotten that oftentimes psychological symptoms to the mind are like symptoms in the body. The body temperature rising is a sign of our bodies fighting off a problem just like symptoms of prolonged sadness or uneasiness are our psyche symptoms that something is not okay. Regarding the question of taking medication or not, most all the research I am familiar with demonstrates that the most effective alleviation of symptoms comes when medication is combined with talk therapy.

So what is this talk therapy? Why is talk therapy different than talking to a friend or your pastor or your spouse? First of all, talking to a skilled professional about your own truth and your underlying psychological patterns can’t do anything but help you.  Psychology is a social science based on research that collects data. More and more research is accumulating to suggest one can change their own life by making a conscious choice to change their behavior.  A recent Consumer Reports Health study shows that patients who were treated for depression and/or anxiety with talk therapy for 13 or more sessions had better outcomes and resolutions than those who only received medicine.  Medicine has become a temporary fix for psychological issues and is contingent upon whether the patient continues the medication.  However, talk therapy with medication is capable of real behavioral change and there are no side effects.

There are many pieces to the puzzle to which we humans are made up of and solving the puzzle means looking at all the pieces, not just one or two.