So whats holding us back from developing these kinds of multiple categories in the DSM, based on genetic or other causes? We dont know enough. But then the committee preparing the DSM and the psychiatrists and psychologists who use it should be sensitive to that. That is to say, a psychologist or psychiatrist treating a depressed person should be sensitive to the possible cause and try to discern it, by gathering psychological data, by requesting biological data, so that he or she can provide better treatment. But few clinicians are doing that. Lets talk about treatment. In another essay in the book, you argue that cognitive behavioral therapy may be on the verge of losing its effectiveness. Why is that? A new therapy usually is effective because its new, and the patient and the doctor think its very effective. It usually takes about 50 years for a therapeutic ritual to lose its effectiveness. For example, psychoanalysis was very effective for about 50 years, and then the therapists lost faith in it, and therefore it stopped working. The recent reviews of cognitive behavioral therapy, which is 50 years old, are beginning to show the same thing. Because it is not the specific ritual that matters, it is does the therapist have faith in this ritual, whether its valid or not, and does the therapist communicate that faith to the patient? A wonderful example is that, under Mao Zedong, psychoanalysis never took hold in China. Now that China is growing more capitalist, suddenly psychoanalytic theory is new there. And so psychoanalysts are practicing in China and patients are getting better. Meanwhile, in the United States, very few therapists practice psychoanalysis, because the 50 years are up.
Posted on: Mon, 24 Mar 2014 14:15:01 +0000
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