The National Council of Psychotherapists
Psychotherapy Vs Medicine
Michael O’Sullivan FNCP
Psychotherapy and conventional medicine have both evolved from the need to treat different aspects of human health. Conventional medicine is concerned mainly with the physical body and psychotherapy with the psyche, which includes mental processes.
Obviously psychotherapy is not an option for someone suffering from a broken leg or food poisoning. Leaving aside for a moment the dictum that ‘everyone can benefit from psychotherapy’ we can look at two main areas where the use of psychotherapy provides advantages of treatment over and above those of conventional treatment methods.
There are two main classifications of problem areas where the conventional approach shows a number of weaknesses. These are ailments with a strong psychosomatic element and neurotic conditions.
Conditions that are referred to as psychosomatic and the patient presenting them must be understood by taking into account the patients personality, any conflicts or stress, life history and social and economic circumstances. Much of the published literature on psychosomatic conditions suggests that patients share common features of personality, which predispose them to certain behavioural patterns. In many cases this can mean exaggerating simple ailments or responding with ‘illness’ to unfavourable circumstances.
Psychosomatic conditions are distinguishable from neurotic conditions such as phobias, obsessions and compulsions. On the surface neurotic conditions are often easier to recognise as they tend to be more consistent and long lasting. Psychological theory also points to a neurosis being supported by repression, with its associated anxiety, tension etc, (in other words personality is not the main cause of the condition) whereas psychosomatic conditions are considered to be a fault of personality.
Conventional medical practitioners are in general well aware that many of their patients come to consultations when it is not necessary from a medical point of view ie, when there is nothing physically wrong with them.
Many GPs respond by writing prescriptions to ‘get rid of’ a bothersome patient while they get on with more deserving cases. This only exasperates the situation, as the patient is not helped to understand that there are better ways of dealing with life’s problems. Some surgeries have responded by employing stress managers and counsellors to work with groups of designated patients, and in general the results of these interventions have been highly successful in reducing general consultations and the demand for prescriptions. In more severe cases a client can be helped by psychotherapy when conventional medicine and other approaches as mentioned have failed in the following ways:
· Conventional methods of treatment tend to be patient receptive, this means that treatment is something that a patient ‘has done to them’. They are given a prescription, offered a procedure or otherwise generally told what to do to improve their health often on the basis of a brief examination. In other words a patient is dis-empowered and can be made to feel reliant on the person in charge of their treatment programme. This undermines confidence and allows existing coping skills to fall into disuse. Psychotherapy empowers the same patient by encouraging them to adopt a more pro-active approach to their problems and in helping them to find their own personal solutions.
· A psychotherapist can offer individual support and can gear intervention to the direct immediate needs of the client.
· A psychotherapist can help to uncover any unconscious psychological strategies which may be inhibiting the clients coping skills, and can further assist in developing other, more beneficial strategies.
· A client can be helped to better understand their own personality and the reasons behind certain behaviour.
· A psychotherapist can also help a client build up self confidence and build a better self image as methods of helping them cope more productively with life’s problems.
· Psychotherapy is a dynamic process that involves the client in his or her own treatment programme. In other words they are empowered through no longer being passive recipients of ongoing, non-productive treatment. The realisation that they do have a part to play in the therapeutic relationship can be very motivational for clients.
· Psychotherapy can also act as a form of education for a better life through greater self-understanding.
· Mind, like body has a predisposition towards health. The role of the psychotherapist is to facilitate this predisposition.