In this morning's New York Times magazine, former journalist Lori Gottlieb wrote a feature titled The Branding Cure, My so-called career as a therapist, about the dying practice of psychotherapy. As a newly minted psychotherapist, she sat in her empty office awaiting patients to flock to her door for her help. They neither flocked nor walked. They stayed away in droves.
No more traditional psychotherapy?
In an effort to find out why, Gottlieb discovered that according to Dr. Katherine C. Nordal in a 2010 American Psychological Association paper titled "Where Has all the Psychotherapy Gone? that psychotherapy as we know it – or at least I know it as 50 to 60 minute face-to-face sessions with a caring and knowledgeable psychiatrist or psychologist – is quickly becoming archaic.
Meanwhile, as "managed care" has declined dramatically, "pharmaceutical companies spent $4.2 billion on direct to consumer advertising and $7.2 billion on promotion to physicians, nearly twice what they spent on research and development," Gottlieb reported from Nordal's paper. Increasingly more and more patients are receiving medication only – 57.8% in 2007 or 30% more than 10 years before.
I find that shocking and sad, but I know it's true.
Having lost my only kidney (yes, I was born with one) to carelessly monitored Lithium Carbonate back in the 1970s and 1980s – iatrogenic acute endstage kidney failure – I know that unmonitored medication can be perilous.
Nordal admits at the outset that "while medication is an appropriate part of a treatment plan for many mental health disorders, psychotherapy has been documented as the preferred treatment for many common psychological disorders." I have learned that medication PLUS psychotherapy is the best route, but that is my experience. My psychiatric experience started in the 1960s, its dark ages with precious few pharmaceutical choices.