The Elephant on the Couch: Side-Effects of Psychotherapy (Berk & Parker, 2009)

I have a friend who was seeing a psychotherapist for many months and when my friend's depression did not lift, the psychotherapist admitted that she was not helping. I was surprised by that admission, not something I've heard of frequently from that profession.

But I was to be even more surprised.

Wanting to help my friend find other potential support for his depression, the psychotherapist referred him to her psychic.

I'm disappointed to say that my friend (a super smart sciencey-type guy) went to the psychic. I guess that speaks to how desperate he was.

Not surprisingly, the psychic offered nothing useful.

My friend still battles (at times disabling, with suicidal ideations) depression.

On a similar note:
I have another friend, a Social Worker, who works in a hospital's cancer unit as a counsellor with terminal patients. The counsellors are instructed not to bring up death with the dying patient, and not to encourage discussion of the patient's feelings / thoughts / meaning about their imminent death.

So its not just the elephant in the room that's not being talked about at this cancer unit. Its also the Grim Reaper. Waiting impatiently.

 

I had depression and thoughts of suicide for many years. I have been treating myself for the last 5 or 6 years with 5-HTP which works wonders for me. It doesn't eliminate the depression completely but reduces it a lot.

Disadvantages of 5-HTP :

1) It doesn't work for everyone - but then neither do the pills peddled by doctors.

2) The most frequently manufactured products are in doses of 100mg. 200mg doses are also easily available. In my opinion these are both too high a dose to start with, and 50mg is the best starting dose.

3) 5-HTP raises cortisol. (I realise some people might consider this an advantage, but I don't.) I've never seen any research which looks into how much it actually does this. I suspect the effect is slight, but can't prove this.

Advantages of 5-HTP :

1) In many countries, including the UK, 5-HTP is available over the counter and online without a prescription. Reading reviews on Amazon is well worth doing.

2) If it is going to work you'll probably know within a week, unlike prescribed SSRIs which people are told won't show an effect for at least 6 weeks. If 5-HTP doesn't work for you then you won't have any problems getting off it if you've only been on it a week. If you've been taking an SSRI for 6 weeks and it doesn't work your doctor is likely to raise your dose and persuade you to continue taking it for another 6 weeks (at least). By the time you decide that it really isn't helping you could have been on it for a few months and you may suffer withdrawal symptoms. For some people these withdrawal symptoms can be severe.

3) If you take 5-HTP and find it helps but then want to come off it for a some reason I haven't heard of anyone having any difficulties attached to withdrawal, although personally I would always reduce dose slowly. I have stopped taking 5-HTP in summer a couple of times and had no problems doing that.

Other info

1) I've only ever tolerated or needed 50mg 5-HTP per day, and I currently take it 5 days a week. Bear in mind that some people need far higher doses than I take - my dose is low. It is not unusual for people to end up taking, say 50mg or 100mg two or three times a day. If it is only taken once a day then evening is best because it increases levels of melatonin.

2) If someone is already taking drugs that affect serotonin then taking 5-HTP is NOT a good idea. There is a possibility, when mixing anti-depressants of any kind (and some pain relievers too) of a condition called serotonin syndrome, which can be fatal.

https://en.wikipedia.org/wiki/Serotonin_syndrome

Anyone reading this should always do their own research. There may be reasons why 5-HTP isn't suitable for you that don't apply to me.

 

If patients were given information about possible adverse effects or simply that it may not work, they might stop earlier when less harm had been done (or in some cases never start).

However, unlike with drug therapies, information on possible adverse effects is generally not given with psychotherapies or indeed many other non-pharmacological interventions.

 

!! What do they talk about then? What a nice day it is?

 

Canadians always default to talking about the weather, so probably.

 

How unbelievably cruel!

If it were me I would rather no counsellor at all than a counsellor taking up my resources deliberately not giving me the help I need.

If they're not going to help folk come to terms with death and dying, why are they there at all? Sounds to me like they should be fired.

 

Both my brother and the husband of a friend's appear to have experienced a similar sort of psychotherapy whereby traumatic events were " put in a box". The memory of those events can no longer be accessed consciously at least. Both use the same terminology so it sounds like they had the same sort of therapy.

Although this may be a short term solution to coping with the events long term it has caused problems for both families. Sadly as sometimes happens in families history repeats itself and both my brother and my friends husband are ill equipped to deal with this because the memories of the previous experience are in the box.

Although the conscious memory maybe in the box, I'm not convinced that the emotions relating to those memories have been so well contained.

I say to my brother you must remember so and so which happened in our childhood and he genuinely doesn't. He has very few memories of childhood at all.

Having seen the impact of this kind of therapy on both families I'd advise anybody who comes across it to be very cautious indeed.

 

I'm a bit conflicted about the personality disorder question. Mental health professionals treat ppl with this diagnosis with utter contempt. So I agree the diagnosis should be banned, it does more harm than good. Also, I'm not convinced it's a disorder as such. Just a problematic way of thinking, feeling and interacting.

But the way that some troubled people attribute their problems to "past trauma" can be hugely damaging to those around them, and I don't like the way therapists encourage this. If you've ever talked with decent parents whose PD offspring have blamed them for everything that went wrong in their life, you'll know what I mean. This sort of other-blaming has been going on too long in mental health settings, and needs to stop.

Whether we agree with the label or not, we've probably all known a person with a BPD-like temperament - someone who's funny and entertaining, who seems to want to get close to us fast (perhaps a little too fast), and they're quick to share their harrowing stories of multiple past wrongs that have been done to them. But then as soon as this person feels let down by us in some way, everything switches. We get added to that list of terrible people. We hear our past actions being recounted in ways that are unrecognisable. Its not necessarily lying. Its the powerful biasing effect of their strong emotions.

Anyway, if you've ever had that experience you'll realise that accounts of past "traumas" in highly emotive people should be taken with a pinch of salt. They can be very hurtful - to the person being accused.