A Psychiatrist Airs His Professional Doubts
Published July 22, 2007
Grim reading indeed.
Over 30% of the adult population will visit their Family Doctor in any year. 30% of them, 10% of the population, are considered to have emotional problems.
For some reason these emotional disturbances are treated as if they are mild forms of mental illness. They are not. Very often we are seeing stress caused by poor coping styles or skills. They are treated as if they have, or about to have depression, anxiety, or panic. The vast majority are offered medication. They should be offered alternative drug-free modalities such as Cognitive Behavioral Therapy or Psychotherapy.
Of those referred to psychotherapy much less than half will get past three visits. The major explanation of 'file closure' in these cases is drop-out. 'Completion of therapy' ranks as one of the least given reasons.
Are there any bright points? Yes there are:
CBT: Cognitive Behavioral Therapy is causing a rethink of treatment. It asks a patient to think about their feelings and behavior and thus influence subsequent behavior. This is a good answer for the patients with emotional problems in primary care. It enhances coping skills. This is a different approach from the attempt to cure an illness that does not exist. We can now offer Online CBT in a Self-Help format over the Internet.
Compliance and adherence: This is not a problem inherent only to Psychiatry. Doctors are not trained to explain and ensure compliance. They do not have the time to do simple weekly follow ups. This is easily done using the Internet web sites.
Medical Management: Uniform systematic treatment is essential. It is possible to ascertain accurately patient needs and utilization. It is possible to follow the two parameters in real time. Thus ensuring efficient performance of the Mental-Health system as a unit. Alongside this, the individual patient is never unknowingly lost. This can be done in real time and online.
Yes there is a lot of criticism here. Is it justified? It certainly is honest and based on my clinical experience. I have hopefully done my part by initiating a discussion and providing solutions, as I see them to the problems as I saw them.
- A Psychiatrist Airs His Professional Doubts
- Published: July 22, 2007
- Type: Opinion
- Section: Sci/Tech
- Filed Under: Sci/Tech: Health/Fitness
- Writer: Dr Michael Benjamin
- Dr Michael Benjamin's BC Writer page
- Dr Michael Benjamin's personal site
- Spread the Word
- Like this article?
- Email this
Save to del.icio.us
Comments on this articleComments
Most people involved in the Mental Health System did not learn proper skills in life because they were sexually abused or physically abused as children.
The lies and manipulations, and living in lies, that results, as well as the lack of felt ownership of their bodies means these people do noyt feel - and are not - in cotrol of their lives.
There is no strict divide between "orgnanic illness" and psychological problems rooted in childhood. There is as great or greater a correlation between surviving an abusive childhood and getting a diagnosis of Schoizophrenia or Psychosis as an adult.
On average survivors or Childhood Sexual Abuse spend years in the system before getting appropriate diagnosis if at all. Most never do.
Psychiatry is forced into a mad world by the division of mind and body medicine into such false camps. We are seeing this with the increasing realisation that the strict barriers erected between mind and matter by Descartes do not exist and the thinking that has lead to in medicine and elsewhere is faulted.
Add your comment, speak your mind
(Or ping: http://blogcritics.org/mt/tb/66673)
Dear Dr Benjamin,
I found this piece quite interesting. I'm currently engaged in a toe-to-toe exchange with the MHRA in the UK over its assessment procedure (it appears to amount to rubber-stamping the opinion of the company applying for a marketing authorization). I'm posting the correspondence on the Uncommon Knowledge depression forum (UKDF), in the hope that the MHRA's evasive replies will be more influential than anything that I could say.
Which brings me to the point, I suppose. There are those members of UKDF who have appear to have serious issues, but for the most part, people just want to have somebody to talk to about their "stuff". People don't appear to "want" or "need" drugs - they appear to need solutions, and just learning how other people have dealt with similar issues to their own is often valuable. The more serious cases are those who are at the point where they absolutely refuse to try anything new, and won't even discuss their issues in depth, even though they've taken the effort to visit a support forum.
Anyway, I'm not sure if that adds anything to your experience, but, as you suggest, at one point, above, life skills are what most people are lacking. No drug provides those.
Best regards
Matthew Holford