The truth about most therapy! (with bonus tips)

Bravo to Therapist/Writer Jonathan Alpert, who confronted problems with psychotherapy recently in The New York Times.  His article, “In Therapy Forever – Enough Already,” is terrific.  Here are a few comments from me, followed by a link to his original article.

1) Despite the fact that most people have “problems in living” (my term) rather than “mental disorders,” clients and their therapists have allowed themselves to be held hostage by the medical model and the insurance industry.

Heads up, folks:  Using your insurance to pay for therapy will require a mental illness diagnosis that will stay on your medical record – forever!  In some cases, your therapist’s records will go on electronic systems and both of you will lose control over this information – forever!  Therapy, though, shouldn’t last forever.  If you need support, bite the bullet and pay a therapist out-of-pocket. Most fee-for-service therapists will negotiate fees with you because we don’t want your insurance company to be in charge of your therapy — and we’d rather invest our time in you than haggling with them about whether you deserve care or not!  Ethical therapists do this: If you can’t afford us, we’ll give you referrals to resources you can afford.

Bonus tip: The newest edition of the bible of mental disorders, Diagnostic and Statistical Manual of Mental Disorders, which is anticipated in May, 2013, is controversial because it adds new categories of mental disorders which many therapists believe pathologizes problems in living. Read more here.

Bonus tip:   Usually, less expensive therapists are less experienced — so typically it takes them longer to get the essence of you, which may not save you money in the long run.

2) If a therapist needs to hear your whole life story, unless you really really want to do this and you have money to spare, find another therapist. Talking about your past leads to great insight.  Insight leads to … more insight. Not change.  We don’t heal the past by rewinding our history. We heal our yesterdays by dealing differently with today’s situations.

Double bonus tip:  This doesn’t just change your perspective about your past. It creates the possibility of a different future!

3) Even you do suffer from mental illness, find a therapist who understands Functional Medicine and collaborates with a Functional Medicine specialist.  Conventional psychiatrists are trained to believe in the biological basis of mental illness, but few of them offer the testing that is now available to more closely determine the nature of your condition.  The primary tool most psychiatrists have to offer is pharmaceuticals. Don’t get me wrong – they mean well, but it’s a guessing game with side effects, and you’re the one paying that price.

In my experience, FM specialists, many of whom are licensed medical doctors, will read your lab tests more comprehensively, know about additional testing resources, and can also offer nutritional options and top-notch neutriceuticals/herbiceuticals that have fewer side effects. A functional medicine friendly therapist will recognize the difference between “problems in living” symptoms and the more embedded “mental disorder,” which usually means you’ll get more effective support. If you are in the San Francisco area of the USA, contact me and I’m happy to refer you to FM practitioners I know. Otherwise, the Institute for Functional Medicine website is a great resource for finding a practitioner.  If your situation involves alcoholism or other addictions, the Alliance for Addiction Solutions is a good option, too.  (Disclosure: I am a member of the AAS, and although I can’t personally vouch for everyone in this organization, I see great dedication to serve the needs of people for whom conventional addiction treatment has not worked).

Summary: We are all an experiment of one when dealing with any medical situation.  If you have to be an experiment, wouldn’t you rather get some tests before you take a pill?  Wouldn’t you rather try a treatment that has fewer side effects before going to one that has more side effects?

The bad news:  The insurance industry does not yet reimburse for FM testing or treatment.  This is a social justice issue because it makes these treatment options less available for people whose budgets are stretched.

The future?  Make your voice heard by telling your practitioners and your legislators that you want freedom of choice regulations included in any state or national health care laws. This will increase your right to get the integrative and preventative care, including functional medical approaches, that you deserve.

Click here to read “In Therapy Forever – Enough Already,” Jonathan Alpert’s essay in The New York Times,