Friday, February 29, 2008

Pills or Skills?

I stole this title from an article I read many years ago about ritalin for kids with ADHD. Last week I watched The Assassination of Jesse James by the Coward Robert Ford. As I implied in my last blog, Jesse would have been medicated today, or at least someone would have tried to medicate him. His mood swings were pronounced and deadly.

The nature-nurture debate has always fascinated me. If it’s nature, medication makes a lot of sense to me. Even with nurture, perhaps Jesse’s parents’ were abusive and he was traumatized, I can see the possibilities.

But how do we remain unique, exciting and daring if we’re in a prozac fog? I’ll add creative as well, although I certainly know a lot of creative souls who take their antidepressants religiously.

What does this have to do with life coaching and psychotherapy, anyway? Simply this: if you’re interested in change, medication sometimes reduces the motivation for change. You start to feel better, even if you’re in a bad situation. Don’t get me wrong, I’m not saying that’s necessarily bad, and clearly it’s essential for survival at times. Many of my most interesting clients take medication. But where do we draw the lines?

I recently attended a psychopharmacology workshop. A requirement, interestingly, for license renewal for psychologists in the state of Georgia. The presenter showed a few clips from Sophie’s Choice. They depicted her depression and PTSD quite well. Later I thought, you want to medicate Sophie? Styron himself relied on antidepressant medication and his book, Darkness Visible, is an awesome look at depression.

The point is that we have to consider these choices carefully. I know, like you wouldn’t. But honestly, there are a lot of unanswered questions in the medication arena. It makes me wonder about my own recommendations, the standard in psychotherapy being, well, if we don’t see any improvement in [fill in the blank based on severity] weeks, let’s discuss medication again.

Check out When do meds make the difference?" in the APA Monitor on Psychology at, Listening to Prozac, by Peter Kramer and Ritalin is not the Answer, by David Stein.

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