So, most people just rely on medication
because that's what they have offered to them. They don't realize therapy is a
a potential thing they can engage. Many times the doctors that they see
only have medications to offer, they're not trained in therapy they don't have time to
engage in therapy,
they don't have therapy services on site, and when they do
recommend people go see a therapist or counselor,
70% of time people won't go. They feel insulted, they feel,
my doctor's writing me off, they think I'm crazy, or something, I'm not crazy.
No, we're not talking crazy, we're talking about human experience right?
Talking about people who get a recommendation from their physician that they engage in
counseling services. The vast majority won't do it.
Some people go, 'I don't have time for that,' but they make time for doctors appointments.
They say, 'I don't have money for that,' but they might buy medications for years on end.
Right? But what we see is they actually have very similar efficacy.
Both work. This is a consumer reports,
report, in 2010. Alright, this is
asking people who have been in the process
of treatment for whatever mental health concern they have
what works for you. It's not a scientific study it's just
asking people, but in that sense you get peoples' actual opinions,
right? What do people think? Well, combining 1500 reports of satisfaction
for treatment of anxiety, depression, very common issues with people,
how helpful they found their doctor or therapist, the degree of change they reported,
from their emotional state from beginning to end of treatment, or the point they were asked,
record on a 100 point scale, conversion there,
what you find out, people who have mostly medications as their treatment
paradigm, about 70% of people,
find that effective within one to six visits. Now keep in mind, medication visits aren't
going to be weekly are they?
You see your doctor, they prescribe you medication,
hopefully they'll want to follow up in a week, or two, or three to just to see if everything's
going okay with you.
Hopefully they'll ask you about suicide risks,
which is something I've shown you many people are averse to.
They are trained to, but oftentimes won't. They'll
make big assumptions about people being OK when maybe they're not. The
majority of people who suicide,
die by suicide, have seen their primary care provider in the previous month.
In some ways they might have been reaching out, Hopefully people would ask you back,
but mostly meds, you get equivalent.
One to six visits, seven or more visits, about 70% of people report an
improvement.
That's good. That's real good. Look here at talk only though,
about the same. Roughly the same with a little bit more,
little bit more efficacy the longer you go.
That might be a weekly thing. That might be a thing where you go
each week to talk to some body about your life,
where they're trained not to be talking about their own issues,
and not to be judging you, but to be asking you
very specific types of questions before relating
hypotheses in their mind about what might be going on and feeling that back
to you in a way that you might be able to
have some insight about yourself in a way that hadn't occurred to you before.
Then giving you suggestions for things you might try to alleviate problems in your
life or
to make your life more optimal, and you choose whether or not to do those.
Nobody makes you do that, you choose to do that.
And what we see with talk points of medication, a little bit better,
little bit better, which is consistent. It's pretty consistent with long-term
research
other scientific, more scientific nature, which is to say this,
medications work, but one of the problems with them is when you go off of them,
you tend to have high levels a relapse. Meaning, the problem comes back.
Talk therapy works equally as well,
but you have a lower incidence of relapse because people have actually changed
the circumstances that might have been surrounding the onset of the issues,
and/or their interpretation of themselves or the issues,
and/or adopted some kind of coping strategies that make them
more capable of dealing more effectively with the
stressors they find in their lives. So they actually build different
experience for themselves, and the best outcomes seem to be when you combine the
two.
Especially with depression, where some of the core
symptoms are lack of energy, apathy
right? And the idea is that if you take the medications it might actually bring back the
energy that you need to engage top
therapy effectively and get the maximal gains
So, it works. Why are people scared of it? Why do they think there's something wrong with
them?
I've been to a therapist. I am at therapist,
a licensed clinical psychologist. I had some difficulties in my life
several years ago. They were vexing me.
I didn't meet criteria for any mental illness,
although I was somewhat depressed.
I didn't meet criteria for diagnosis,
but I used my the EAP, employee assistance, and
I went to a licensed clinical psychologist.
I went about four times, and I got some insight.
There I was, forty years old with all this training,
and some stuff that was core to how I lived my life did not occurred to me,
until somebody else heard me telling them
answers to the questions they had for me, they formulate some hypotheses,
fed it back to me, and I contemplated it.
I was like 'damn.'
That had not occurred to me before.Yes, there's probably some validity to that.
Let me address it.
And it helped. It helped me, and I ain't afraid to say that.
Who would be? Most people. Why should they be?
They shouldn't be. Life is hard. Life is suffering.
There is help available if we'll only reach out and take it. Psychotherapy
itself
is the process by which
mental health professionals, and there are a variety of types,
licensed, trained, that help people recognize, define,
and overcome psychological and interpersonal issues.
Difficulties between people. Does it do any good?
Yes, now we're looking at psychotherapy.
We've already looked at biological therapies, now we're looking at
psychotherapy. Its just one meta-analysis, there's of bunch
of studies that corroborate these findings.
There's a placebo effect, and a pretty big one.
Is that the case with biological therapies? Drug therapy? Absolutely.
It's a huge placebo effect. In other words people
who are at the break of not knowing what to do, most
people don't go, 'man, I should go to therapy.' That's a good idea. That
would help me really reassess my life and make a better plan for how to
deal with difficulties I'm encountering
right? When they go to therapy what? The shit has hit the the fan
right? It is so bad that they're finally like, 'god, I guess I might as well
go to therapy.' Not, 'I should go, but I might as well,
because it's that bad for them right? So
offer any hope whether it's in medicine,
or talk therapy a lot of people start to improve right there because maybe their
past the point at which you got the worst, alright.
And it just gets better from there, it may be because they are activating their
own
coping mechanisms by going into therapy, that they've actually past a point and
have started
actively in proactively engage in doing something differently.
But what we see is people start responding in big ways
just might going whether its medicine or talk therapy right?
But to be an
empirically supported treatment
whether medicine or anything else, you have to do better than placebo,
you have to do better than placebo,
and we do about twice as good as placebo,
and medicines similar. So the placebo effect is real,
it's important to understand it. You don't take it away from people.
I've met people who said, 'man I started taking anti depressants, I'm already
feeling better, been taking them about a week.' I'll go, 'oh you can't be feeling better It ain't had time
to work yet.'
Stop feeling better and wait for it to work.
If you're feeling better, good! That's what we're after. That's what we want.
Alleviation of suffering and hopefully some kind of engagment
in a new way of looking at yourself or the world, a or new way of
engaging the world so that you can avoid
similar situations in the future so it does work. It's not just a bunch of
touchy-feely bullshit no matter what people say
that you hear.