On September 29, 2013, The New York Times published an opinion piece lamenting the underuse of psychotherapy in favor of psychotropic medication, “Psychotherapy's Image Problem” by Brandon A. Gaudiano, (nytimes.com). The author stated that part of the problem resulted from the reluctance of psychotherapists to abandon “old-fashioned Freudian therapies.” Four letters to the editor were published in response to this op-ed article, two written by members of APsaA.
Published: October 4, 2013
Brandon Gaudiano correctly depicts the contemporary mental health scene, where psychotherapy is devalued in contrast to medication management. Yet Dr. Gaudiano himself has to devalue what he calls “some old-fashioned Freudian therapies,” despite the fact that both short-term and long-term psychodynamic therapies have been demonstrated to be effective in certain conditions.
In fact, all modern therapies owe a great deal of their therapeutic impact to principles first articulated by Sigmund Freud, such as the importance of the therapist-patient relationship. Even medication management cannot be accomplished effectively without a powerful bond between doctor and patient. Without such a relationship, no treatment can be successful.
Leon Hoffman
New York, Oct. 1, 2013
The writer, a psychiatrist, is co-director of the Research Center of the New York Psychoanalytic Society and Institute
As a psychiatrist and psychoanalyst, I constantly compare the value and effectiveness of each type of treatment. While I agree with Brandon Gaudiano that Freudian excesses are part of the reason that psychotherapy is undervalued, I believe that the dichotomy is not medication or psychotherapy, but rather practitioners capable of recognizing the value and contribution of each modality. My skill as a psychopharmacologist rests on my capacity to listen closely and carefully, rather than decide that a patient meets checklist criteria for a disorder and therefore gets a particular medication. I wish more psychoanalysts understood the value of biological psychiatry and that more psychopharmacologists understood the value of listening and talking. In the meantime, I have a very busy practice filled with patients willing to pay cash out-of-pocket who could not get their doctors or psychotherapists to consider both brain and mind.
Marcia Kaplan
Cincinnati, Sept. 30, 2013
TAP welcomes letters to the editor. Letters must be less than 350 words long. Letters will be printed as space allows and at the discretion of the editorial board.