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Post by Admin on Jul 27, 2015 10:04:27 GMT -4
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Post by Hiren Darji on Jul 27, 2015 10:34:48 GMT -4
Psychiatry’s Identity Crisis was good educational article that allowed me to learn great deal on various crises in the field of psychiatry. It was quite perplexing to read how we have not managed to have more research in this field and how we can treat the patient’s differently compare to decades before. New technology and new drugs are developed since the 1940’s but they are still as not effective compare to the drugs or treatment modalities that were created back then. Even with the advances in technology I would of imagined that we would have better understanding on various aspect of brain. Understanding the brain will give us insight on how we can consider treating various types of neurological and psychological conditions. Dr. Markowitz study on PTSD the statics were impressing showing how various treatments can help the patient deal with PTSD. It showed that interposal therapy was 63 percent effective compare to 47% with exposure therapy.
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Post by Hubert Pare on Jul 28, 2015 0:29:35 GMT -4
Therapy is defined as the process of developing a narrative that helps bring integration and coherence to a chaotic life. It has long been described as the "talking cure." In the first layer, therapy involves experiencing our feelings, labeling them in real time, and articulating them out loud. In the second layer, interpretation and connections to the past and present. The third layer involves emotional and sense integration into our current identity--this helps us transform our future Reality. From the cumulative outcomes portrayed by this articulation, one can submise that a combinatory approach to a particular condition, such as PTSD, Anxiety and other mood disorder my be of quantitative value. The strength of a combined psycho therapeutic and psycho pharmacologic approach cannot be ignored. The impact of such approach on a previously recalcitrant condition may be overwhelmingly positive, like discussed in the article.
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Post by Cheryl Stephens on Jul 28, 2015 18:34:21 GMT -4
From this article, I agree in the sense that there is no quick 'biological fix' for someone who has gone through a tragedy or has been exposed to some sort of deprivation from what we call a normal life. Yes, psychotherapy may take longer than a medication but it is, in my opinion, a necessity for the full spectrum of psychological healing. In this article, the new study of optogenetics is brought up as a therapeutic option that may lead to a breakthrough in treatment and how we assess our understanding of brain abnormalities. I truly agree with what this article believes in that psychotherapy used for PTSD needs more consideration both in research, funding and awareness.
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Post by Victoria Mazzella on Jul 28, 2015 19:04:30 GMT -4
I think an interesting point of this article was that not all conditions can be treated with biologic therapy. The medical community seems to be going towards prescribing a pill as a quick fix for everything these days. Psychotherapy is a field that should be getting more attention and research money in order to fund it for patients with histories of sexual abuse, PTSD as well as other issues. Although biologic therapy has not seen any new neurotransmitter or receptor development, it’s still a pertinent avenue of treatment. I think it’s important to evaluate patients based on their needs and mental health goals. Some may benefit from just the medicine due to chemical or hormonal imbalances. Other patients may just need therapy and personal interaction to deal with their health issues. I think most patients fall into the category of needing both biologic therapy and psychotherapy.
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Post by Anjani Singh on Jul 28, 2015 22:51:03 GMT -4
I found it interesting that for once, a psychiatry article was not only focused on psychotropic medications, but actual therapy too. I think that therapy part of psychiatry got lost in the grapevine through the entire innovation of these newer drugs. Psychiatrists aren’t just pill pushers, they are essentially there to help, to talk to when no one else can, and to be a guide for how to deal with mental illness. Psychotherapy is extremely essential because it allows not only strengthens the relationship between the physician and psychiatrist, but allows more insight to an illness and gives the physician more options on how to treat it. Interpersonal relationships, as noted via the article, was more effective than the exposure therapy even because it depicted how important interpersonal relationships were to the patient and used that as an effective way to help the patient. I thought that was one of the more interesting finds in the article. I also believe that while medications may be the quick fix, psychotherapy is necessary to understand the patient better. In my option, the best option is to best combine the two and truly allow more research for psychotherapy, so there are other options for treatment. As the article stated, more Americans want psychotherapy more than meds, so it only makes sense to give the people what they want.
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Post by Janak Patel on Jul 29, 2015 18:09:02 GMT -4
Well i clearly agree with this article. Psychotherapy should be the first choice when it comes to treating psychiatric patients. In every disorder patient always have a reason/cause for what they are behaving. So we need someone who can understand them, and support them mentally. For sure drugs can not do that. To progress in this we need more research, we need more therapist who can be funded so that we have more therapist in our society. Everyone wants a quick fix, so pills are the first choice, but in long term patients are going to get tolerance to their medications. Dr Markowitz from Columbia University proved it that he can treat PTSD with Psychotherapy, then why not other conditions. The Government needs to put more effort, show some more interest so that we can cure the disease rather than just giving them a maintenance therapy.
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Post by Arachristie Otero on Jul 29, 2015 18:38:14 GMT -4
Today, the psychiatric field is facing a major debate between how to confront mental illnesses: Psychotherapy or Medications? Stated in this article, “psychotherapy has been shown to be as effective as psychotropic medications”. The data is clearly evident, the next step is on us, as physicians treating this different illnesses. In fact, for most of them, I truly believe psychotherapy is the way to go, which turns to give patients not a stable condition but also a better way of approaching life and to manage their symptoms. On the other hand, sometimes patients will need a little help with the medications, and we can encourage them to do better everyday, that way they can jump from drugs to therapy. Most people, will prefer to do therapy instead of drugs, some other will think therapy is not effective, so they will prefer a prescription to be sent to their pharmacy. It turns out, that there is a chance that they will prefer pills, but most of them don’t want to take them. I’m sure that with time, more and more methods of psychotherapy will be available and more and more medications will come to the market that will present as “the method to go”. The author exposes a beautiful sentence in where he says that “there is no pill and probably never will be for any number of painful and disruptive emotional problems that a person can have”, there is, when we need to work with the patient’s state of mind and way of living. Also, most of the time, there is some sociocultural issue related to a patient’s behavior/condition, we need to keep that in mind. At the end, both of them will play a role in medicine.
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Post by Vani Zutshi on Jul 29, 2015 22:19:12 GMT -4
I think this article was interesting because it makes one realize how much more room there is for new findings in psychotherapy research as compared to psychotropic drug research. Although there have been developments in psychotropic drugs which have made them safer and more tolerable, it seems they are not much more effective compared to the older drugs. This makes one question why more of the NIMH research funding doesn’t go towards research in psychotherapy. I think this article brings about the point that mental health providers should always consider psychotherapy when appropriate, as it is true that not all psychological problems will be solved by simply administering psychotropic drugs. While these drugs may help with the symptoms of the mental health disorder, a majority of patients with mental health issues have causes of these issues that could be better solved with psychotherapy.
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Claire-Louise Young
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Post by Claire-Louise Young on Jul 29, 2015 23:04:19 GMT -4
Psychiatry is a multi-disciplinary field. It seeks to understand the patient from a biological, cognitive and social perspective. As such, the psychiatry should not limit its treatment approach to a biological perspective. It should seek to take a global approach. Psychiatry has an inherent fallacy in being able to legitimately measure the true power of social, cognitive and biological intervention training. Much of this is attributed to the inherent variability in the ability to quantitatively objectify situations and treatment responses. Despite this, psychiatry needs a paradigm shift. Patients are in need of comprehensive treatment that addresses individual situations. The shift needs to encompass the growing evidence for psychotherapy in treatment plans.
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Post by Venkateshram Singa on Jul 29, 2015 23:53:18 GMT -4
Psychiatry is an evolving field to include forensic and addictions psychiatry in addition to child and adult psychiatry. I found it very interesting that psychotherapy is a field that should be practiced more often since it forms the basis for therapy in addition to just medications. Psychotherapy and medication should be the mainstay of care in any setting rather than just giving medication since in the absence of medication, the patient returns to the stage they were in before the therapy began and once the medication is returned, the patient becomes a different person hence psychotherapy should be an added regimen to the treatment plan. I found it interesting that borderline personality disorder and narcissistic personality disorders can be treated with psychotherapy.
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Post by varsha pawate on Jul 30, 2015 0:35:20 GMT -4
Psychiatry's Identity Crisis was an interesting article. I agree with his overall point that more money should be allocated towards psychotherapy research. In the psychiatric field, there are several drug classes with several drugs listed under each class treating multiple disorders. As side effect profile of drugs are researched , more new drugs are created. I strongly believe that before medications are prescribed, patients should undergo psychotherapy especially in cases where it is beneficial, such as in treatment of PTSD. Psychotropic drugs are important, but one needs to realize that sometimes it is not the best method of treatment. I feel that several patients come for a 'quick fix' and in order to keep them stable, medications are usually hastily prescribed. What one needs to realize is that we should consider the psychotherapy method. If the funding for psychotherapy was increased, people involved in the mental health field would become more aware and more open to using psychotherapy. It is always important to understand why the patient is experiencing what he or she is feeling and to work through the patients issue versus just prescribing the patient with medications.
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Shashank Varakantam
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Post by Shashank Varakantam on Jul 30, 2015 7:03:49 GMT -4
Psychiatric identity crisis, Dr. Friedman came up with some interesting facts in this article. I feel like the nature of psychiatric disorders makes it very hard to get right treatment. To be more accurate field of psychiatry mostly works on evidence based approach, drugs being the easy and faster way of getting results its easy for us to accept and lean on new drugs. Most of the psych drugs in the current market have similar mechanism of action, working on same receptors, most of the times changing into different drug if one doesn’t work is not going to benefit the patient, rather increases the risk of unwanted side affects. Based on the given statistics in this article I totally agree on looking into psychotherapy as future source for treating patients.
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Post by Anurag Prabhu P on Jul 30, 2015 9:10:02 GMT -4
After all these years of advanced research,if there is one department where we still have a lot of scope to improve, then that is neuroscience.
What Dr.Friedman did here is very subtle.To compare and contrast two very potential techniques,and by the end of the passage,leaving the reader thinking more about it without actually favoring one of them shows his expertise in writing.
"The brain is notoriously hard to study and won’t give up its secrets easily."I have to confess,this statement has to be my favorite in the whole article.
We probably have to be a little more patient to let Psychotherapy prove its efficacy and compete with Psycho-pharmacology when it comes to decision making on what treatment a patient should be given.
Sure,ECT is a much appreciated and practiced technique world wide but it is not going to be like that for very long from now. I am sure the research and advances in the field of Psychiatry are only going to go up-slope and that too exponentially. I am looking forward to that day where I could talk to new budding medical students that there used to be a technique called ECT and it used to do wonders. By that,what I mean and want to convey is that a new technique is surely going to come up in the next few years which will do wonders.
Unfortunately the "Decade of the Brain" did not yield much info but lets just wait and work on improving the quality and techniques of care in the field of Psychiatry.
To expect just biological therapy to work and improve the quality of life of people with personality disorders may be a little greedy for us Psychiatrists,but we cannot deny the fact that we are in a better position when it comes to treating personality disorders compared to what we were doing 10 years ago.
Coming to Dr.Markowitz's work,if he does come up with an established set of guidelines where we can treat PTSD patients without exposing them to that very same emotional turmoil again and again,then one can only imagine how great a favor he/we would be doing to the PTSD patients we would see in the future.
I am only inspired and motivated now,after reading this article,to know/work more in the branch of Psychotherapy.I just want to thank Dr.Friedman for this thoughtful and intriguing article.
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Anuhya Vallabhaneni
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Post by Anuhya Vallabhaneni on Jul 30, 2015 9:20:58 GMT -4
This article emphasized on the point that neither psychopharmacology nor psychotherapy are superior to each other. There is no quick fix especially for patients suffering from PTSD, MDD and other illnesses. I have got the opportunity to work in VA PTSD clinic and I have seen veterans benefit equally from both pharmacotherapy and CBT. Its sad to read that the funding for psychotherapy research is given less importance lately compared to research on psychotropic drugs, we should definitely work on improving and finding new psychotherapy techniques we cannot give up on it yet. I personally feel that treating the patients with psychotropic drugs alone is just the symptomatic treatment and not treatment for the root cause, treatment should be based on wholistic approach with both psychotherapy and pharmacotherapy. Striking a balance between both is the key.
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