(This is a response to an email)
Louis,
As I see it (please correct me if its wrong), you have opted to think of psychotherapy as falling outside the realm of mainstream psychiatry and medicine, since it has wider and more challenging roles to perform.
While this is a refreshing and interesting line of enquiry, and I wish you all the very best in the venture, my concerns have been rather more pedestrian.
I see the virtual hijacking of the research and clinical agenda by biological psychiatry. While it has a legitimate place in the branch, the elimination of other approaches looms large as a distinct threat, if not in reality, at least in the perceptions of the rank and file of practitioners.
Both psychoanalysis, and committed practitioners of psychotherapy, have commonly responded by either opting out, or falling in line. Those who opt out claim that the medical/scientific/evidential approach is ill suited to psychotherapy/psychoanalysis, since it cannot capture its rich myriads. Those who fall in line have become recent admirers of the biological approach. And you know how recent converts can be.
Both responses have not really helped the cause. I believe the psychosocial approaches must join the good fight. They must produce strong evidence that they work. They must conduct population studies, use rigorous research design, use biostatistics, and prove that they really help. They must produce their own Diagnostic Manual if they do not agree with DSM or ICD. They must suggest changes to the two if they agree with them in principle but find areas that need change.
How can the legitimacy of the approach be proved except by joining the fight? How can the benefits of the approach be offered to the suffering except by proving that it works? And proving it in a language and manner of discourse that the present world understands? Which is the scientific-evidential world. Admitted, it may have problems, and drawbacks. Still, it is the language of present discourse, and on legitimate grounds. For the present world will only respect evidence, or opinions backed by evidence. All else may be worthwhile, but will not be followed on a large scale. And if the psychosocial/psychotherapeutic/psychoanalytic has to benefit people on a large scale, it must produce scientific evidence that it works.
Only then will there be a renaissance of these approaches. Otherwise lets be ready to accept the decisive shift towards the biological, and confining of the rest to the fringes, to be gradually obliterated. Eventually.
This is my submission to you, Louis. Please feel free to express your self. I am sure you will have a lot to say.
Warm regards.
Ajai
17 June 2006
P.S. Please do also read Psychiatrists as Psychopharmacologists at
http://mensanamonographs.tripod.com/id15.html
Posted by psychiatrist400080
at 11:46 PM EDT
