Does Medication Interfere with Motivation for Psychodynamic Treatment

Some analysts express concern that medication treatment will eliminate the symptoms that motivate patients to enter and continue psychotherapy. There is no question that psychic pain motivates patients to seek treatment, and relief of that pain will eliminate the motivation to attend psychotherapy sessions for some patients. Fifty years ago, in the heyday of psychoanalysis, and in the absence of effective alternatives, many patients pursued psychoanalytic treatment for anxiety and depressive disorders. It is not clear how often analysis was the indicated, or ideal, treatment, or how often it was effective for these symptoms. For many patients, combined medication and supportive therapy is quite effective, and sometimes a preferable alternative to depth psychotherapy. Sometimes very concrete individuals show a new capacity for insight once symptoms are effectively treated but may never need extensive psychotherapeutic investigation to maintain optimal functioning.

While introspection and self-understanding have unquestionably been deempha-sized and devalued in modern culture, in the author's experience, patients who are so inclined do not lose interest in pursuing psychological understanding when they are successfully treated with medicine. Patients who are interested in self-exploration engage in psychotherapy whether they are given medication or not. Many patients taking medication express the wish to learn about and master the conflicts that caused symptoms in hopes of making medication unnecessary in the future. Patients attempting to minimize awareness of dependency needs are able to keep those needs out of awareness when they are given medication that relieves symptoms. Not every patient has the capacity for or interest in achieving self-understanding, and medication makes it possible for many to function at their highest level. It is the responsibility of the analyst prescribing medication to maintain a reflective, analytic stance, and to make clear the benefits of psychoanalysis beyond the gains from medication; analyzable patients who feel well with medication and no longer want psychotherapy will be more likely to return for further work if they feel the analyst does not need them to stay and does not disapprove of their decision.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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