MY CURE IS BETTER THAN YOURS
Openmind, No. 117, Sep/Oct 2002
I'm 29 years old, a writer and film producer, and have suffered with anxiety and depression for the last eight years. I have had four major depressive episodes, where I have been unable to work and confined to my bed for periods of at least a week or more. And I anticipate more, not in the desperate spirit of pessimism, but rather in the quiet mood of acceptance. For this is the way I have been made, this is how I am.
The subsequent recovery from these collapses or breakdowns has always been slow and painful. And each one has brought a different treatment, ranging from psychopharmacology, to cognitive behavioural therapy, to psychoanalysis. Lamentably, these different mental health methodologies and practices have never been integrated. On each occasion when I called on them and their providers to help me out of the dark, each of them stood proudly alone, protesting their own therapeutic power and efficacy, almost like rival politicians at the ballot box before polling day.
During one collapse, after my psychoanalyst had recommended that I try and refrain from medication, my GP demanded, 'Psychoanalysis has been shown to be wholly inappropriate in the treatment of severe anxiety. It just stirs things up. And when someone is severely depressed, to withhold medication is dangerous, even cruel!' He went on to prescribe antidepressant and anxiolytic medication and referred me back to the psychiatrist. My analyst countered, 'Drug treatment is a smoke screen, a dampener. It is superficial management. It does not get to the root of the problem. A person's neuroses need to be uprooted at the core. Painful experiences must be remembered, reflected upon, and interpreted. Psychoanalysis offers you significant characterological change, not just bloody management!'
The psychiatrist sought to alleviate my painful symptoms of panic attacks and depression. He did not concern himself with their aetiology, but rather with their diagnosis and containment. He set about treating my anxiety disorder, OCD (obsessive compulsive disorder) through the prescription of medication. Conversely, the analyst was preoccupied with the relentless search for the cause of my mental distress, which he was convinced lay deep-rooted in my unconscious. If I could remember and identify specific earlier traumas, which had been suppressed, and re-live and interpret them, this new understanding and insight would put an end to my neurotic symptoms. In short, this method of digging up and unraveling my past experiences would make me better. However, the cognitive behavioural therapist rejected this form of therapy. He urged me to forget about my past. He was interested in the present and the future. To this end, he was committed to changing the way I felt by changing how I thought.
Amidst this grand therapeutic debate I felt rather lost. The only thing I was sure of was that these different treatments could co-exist rather than stand proudly alone, and that their integration would greatly benefit the user, and would provide more thorough and wide-ranging care.
If these different mental health services can indeed work together and compliment one another, then why are they still seen predominantly as mutually exclusive by their respective providers? The only important thing when someone is in crisis is to help him or her get out of it and recover. It is not about one provider seeking to prove that he or she is more effective than another is.
When I look back, I wonder whether other people have had similar experiences during times of crisis. I am often unclear which came first, the anxiety or the depression. Does the depression cause the anxiety, or the anxiety cause the depression? Is the OCD a symptom of the unipolar disorder, or is the unipolar disorder a symptom of the OCD. Next I’ll hear you ask, 'Which came first, the chicken or the egg?' Unfortunately, I don't have the absolute and final answer to this question, and nor does anyone else. Likewise, I don't know which of my demons came first, the anxiety or the depression. Sometimes I'm certain that I felt sad before I felt scared, and at other times, well … I'm sure that it was the other way round.
Now that I have passed through the different conduits of the mental health service sausage machine – where numerous professionals have either examined my mind or encouraged me to examine my own mind – it no longer matters whether I, or someone else, acquires a definitive understanding of my mental distress. And similarly, it no longer matters that one therapy proves itself to be more effective than another. All that matters is that I feel well.