It's a lot faster – and cheaper – to get a patient on a prescription than on a couch. And new research is showing that these simple economics are destroying the field of psychotherapy and doing a terrible disservice to folks suffering from depression.
When it comes to attacking depression, disincentives are built into the system to minimize the time spent in valuable talk therapy and maximize the experimentation with drugs. A new study exhibits the trend in a chilling way: Psychiatrists now get reimbursed by insurance companies at a lower rate for a 45-minute psychotherapy visit than for three 15-minute visits in which the discussion is about which medication to prescribe.
The symbol of psychotherapy for years was the couch where patients would lie and talk about what was on their minds. I guess we'll have to go with a symbol of a pill bottle now—just like all the other branches of mainstream medicine.
The study from Johns Hopkins estimated that the percentage of patients' visits to psychiatrists for psychotherapy, or talk therapy, fell from 44 percent a decade ago to 29 percent over the past few years. The overall percentage of psychiatrists using psychotherapy also dropped, from 19 percent to 11 percent.
That's a sad state of affairs. The goal of talk therapy is to ease symptoms, sometimes through getting patients to verbalize their emotional issues, then recognize and change their behaviors.
It stands to reason that talk therapy is withering from underuse. The professionals who specialized in talk therapy, with their skills and experience at opening up the fascinating mysteries locked within a patient's mind, are growing old and retiring. They're being replaced by others who are more pill oriented. And their patients are increasingly under the influence of big-bucks advertising that offers a "quick fix" for you to beat the blues. There isn't much marketing for talk therapy — beyond maybe a few old Woody Allen movies.
I believe medications intended for severe depression are too often being prescribed for milder depression—and even the blues. With milder depression, a patient is likely to benefit much more from natural aids such as deep breathing, meditation or prayer, and biofeedback. There is nothing like the help of a gifted therapist to examine negative thought patterns you may not even realize you have. When you recognize such thought patterns and practice new, more positive ones, you will feel and function better. Your brain undergoes the physical changes associated with the healing of depression.
