Psychiatry’s Identity Crisis

Judging from research funding priorities, it seems that leaders in my field are turning their backs on psychotherapy and psychotherapy research. In 2015, 10 percent of the overall National Institute of Mental Health research funding has been allocated to clinical trials research, of which slightly more than half — a mere 5.4 percent of the whole research allotment — goes to psychotherapy clinical trials research…

Anyone who doubts the need for psychotherapy research should consider the case of post-traumatic stress disorder, for which the mainstay of treatment has been exposure therapy.

But we know that many patients with PTSD do not respond to exposure, and many of them find the process emotionally upsetting or intolerable.

Dr. John C. Markowitz, a professor of clinical psychiatry at Columbia University, recently showed for the first time that PTSD is treatable with a psychotherapy that does not involve exposure. Dr. Markowitz and his colleagues randomly assigned a group of patients with PTSD to one of three treatments: prolonged exposure, relaxation therapy and interpersonal psychotherapy, which focuses on patients’ emotional responses to interpersonal relationships and helps them to solve problems and improve these relationships. His federally funded study, published in May’s American Journal of Psychiatry, reported that the response rate to interpersonal therapy (63 percent) was comparable to that of exposure therapy (47 percent).

PTSD is a serious public mental health problem, particularly given the rates of PTSD in our veterans returning from war. This study now gives clinicians a powerful new therapy for this difficult-to-treat disorder. Imagine how many more studies like Dr. Markowitz’s might be possible if the federal funding of psychotherapy research were not so stingy.

6 thoughts on “Psychiatry’s Identity Crisis

  1. Very interesting. Have you read the works of Dr Norman Doidge about neuro-processing? He mentions Dr. Markowitz quite a bit. I have been quite a master of avoidance but after realising that the neuro-fibres don’t rebuild if you keep going around a problem and leaving a black hole, I have tried to be more proactive. I have had a life-long phobia of false teeth and I haven’t confronted them but I have driven further afield and become more confident with my driving.

    Liked by 1 person

    • There’s a reason people have phobias, especially with driving and dental work. Is healthy fear considered a phobia? And if it’s unhealthy fear, then we learn to manage.

      Psychotherapy is great, but it’s expensive. I hope there’s enough information on the internet to help people manage their medical conditions without having to pay for the privilege.

      Liked by 1 person

      • The cost of psychotherapy bothers me, especially as I’m in a health fund and there’s always that gap. I usually opt for retail therapy these days…especially at thrift shops which have great things for a few dollars. Chocolate is another vice. The blog helps a lot too without being a vice. Hope you are having a good weekend. I have just completely rearranged my son’s room to give him more space and I’m hoping that translates into a clear head. We talked about it before he went on his Scout camp so hopefully he’ll like it. xx Rowena

        Liked by 1 person

        • Seems like boys prefer less space and all the chaos of being surrounding by things. Or perhaps they don’t notice all the junk, or think of it as junk. Not saying your son’s room had junk in it, just going by my own experiences. 🙂

          If blogging isn’t a vice, than neither is chocolate. 😀

          Liked by 1 person

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