Brief Commentary on the Role of Medication in Psychotherapy


posted by sooyup

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I am not a psychiatrist, nor am I a medical doctor, so any questions you have regarding the use of medications in your personal well being should be discussed with your doctor.

HOWEVER, I get asked this occasionally and thought I would just post a comment on it.  Medications in psychotherapy:  Medications can assist with various mental disorders, mood disorders and even various personality disorders.  However (comma) medication does not automatically mean that a person who is taking them is automatically going to be able to function and have no more struggles with an issue.  Medication alone does not change a person's psychology.

It can alter the mood or the ability to function.  But the cognitive processes are a learned skill that still need to take place and be developed through the filter of the medication.

For example, in my work with sex offenders.  Many sex offenders are developmentally disabled.  You're usually dealing with abnormal psychology in this community.  They may have anger issues, struggle with self esteem issues, emotional regulation or even empathic abilities.  But with many sex offenders I worked with, they would be given Depo Provera shots to reduce the testosterone in their system.  This reduces aggression and sex drive and allows them to clear their head and not have to deal with the additional issues of biology while working on psychology. 

Despite a decreased sex drive and reduced aggression, they still have to work on identifying their emotional cycles, thought processes and relationship issues because those patterns are still there, even with the medication.   They just aren't as heightened and the individual doesn't so quickly spiral out of control into a destructive pattern while on the medication.  They can go off the deep end even on the medication but the chances are pretty significantly reduced and they still have a lot of work to do.  The issue is when they come off the medication whether they have done enough work to prepare for life's troubles without the medication that they will be able to handle going without it.  Usually they come off it a few weeks/months before treatment ends to see how they handle things.

Medication alone, often, is not the only cure for a psychological disability. 

It needs to be recognized that there are situations though in which medication alone would be appropriate without counseling or psychotherapy.  Sometimes, some issues with, for example, anxiety might simply require a "chill pill" to help a person cope.  They are aware of the issue, and the issue might be entirely biological (chemical imbalance) and then be perfectly fine when on the medication. 

Other times, medication would not be appropriate like in dealing with relationship issues where new perspectives need to be learned and biology doesn't need to be altered.

Or some people might prefer to take the psychological route entirely on their path to fixing themselves in dealing with something like anxiety (I pick this because it's very common and very easy to spot and it's significant in how it impairs peoples' lives).  

My thoughts, personally, having worked with medications are, depending on the severity, consider the prescription and then get the help needed.  When the problem is resolved, pull yourself off the medication and use the tools you learned or acquired while on the medication to resolve the issues entirely on your own.  Hopefully by that time many issues will be resolved and the issue won't require as much work.

This is just a brief layman's terms commentary on the role of medications in treatment.  This is by no means all inclusive.  Different issues will require different considerations, as well as different severity or impairments will all impact the considerations of the roles of medications in an issue.  Talk with a doctor and nobody had better cite this as a source of expertise because the variables on this are just too massive and can require a thorough discussion in their use with a professional.  This is just a minuscule snapshot overview of medications from my training and education.

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