25 Mar 1995 15:11

Talk to your analyst
Isn't that what he's paid for?

Evidence bearing on the charge that it is gaining ground in medical schools because it leads to more perscriptions for medications, hence more money for pharmaceutical firms. (Read in Z magazine, but they're a bunch of ideologues anyhow.)

Drugs are more effective cures of depression, schizophrenia, etc. than psychoanalysis and similar talking-cures. (Assume this as a hypothesis if not a fact.) This doesn't show that psychoanalysis is wrong about the causes of these conditions, precisely because the brain and the mind are so tied up with each other (if not identical). The shrink says (e.g.) that you are depressed because of some unmentionable thoughts about Mother or diapers. The neurologist says it's because something incomprhensible has happened to a chemical you can't pronounce. But, as William James used to say, "every psychosis [=mind state] is a neurosis [=brain state]," so mightn't such unmentionable thoughts --- or the corresponding neural processes --- under the right conditions cause that kind of chemical screw-up, which then becomes self-perpetuating? Conversely, a (modern sense) neurosis might have its origin in a (former sense) neurosis, yet be terminated words from the shrink --- even if the story the shrink tells has no basis in fact whatsoever.

Are suggestions more effective if people are more confident in their sources? It seems a natural supposition. Are people in (say) the US more confident in pills and NMR and proding the brain than in shrinks and words an unmentionables? I wouldn't be surprised. Is neuropsychiatry really so much more effective than psychoanalysis that the difference in cure rates cannot be explained be such an effect? I have no idea. How big would the difference have to be?

My bias is for neuropsychiatry; when I go mad, act accordingly.