Meds vs. “The Talking Cure”

Not that it’s a simple opposition.  Most good practitioners today believe that meds have an important supportive role to play in enabling people to make use of psychoanalysis (PSYA)/psychotherapy (PSYT).   But do check this out:

It’s always good to remember that while the sciences have excellent protocols for generating, handling and interpreting evidence, they have no more purchase on absolute truth than any of our other ways of making knowledge.  This point does not undercut the value of science.  It simply posits the truths science creates not as revelations but as crafted knowledge, the results of many experiments, hard thought, argument, discussion, testing, logic, intuition, quantification, qualification–and its effectiveness can be seen all around us.  To say it is fallible is simply to make a practical point that every scientist worth his or her salt ought to agree with.  Exception should perhaps be made for he physical “laws” of the universe; “irreversibility,” for example, appears to be non-negotiable.  But I think it is still fair to recognize the creaturely factors in how we study and interpret those laws.   This is not a post-structuralist attack on science.  Instead, it honors our amazing achievements in the treatment of mental/physical health.

But I am not a big fan of the notion that the sciences have a special “epistemological privilege” over all other ways of understanding phenomena.  They have particular excellent ways of approaching knowledge, not particularly excellent ways.  The more we learn about the brain, the more stunning its conscious and unconscious capacities for the generation and interpretation of meaning, improvisation, real-time responsiveness to environmental factors, pattern-creation and adaptation, and intersubjective learning appear to be,  These are capacities that benefit enormously from training and experience, and as I have argued elsewhere, they are capacities brilliantly aided by training in the arts and humanities, and they are also capacities brilliantly aided by PSYA/PSYT.  Meds affect brain chemistry in potentially helpful ways, but (so far as I know) there is little evidence that they remake the neuronal networks of associations among memories (episodic and procedural), sense-perceptions, and abstract symbolic activities that make us who we are.  These “associational pathways” are in fact the result of lifelong (and beyond) co-creative interactions between our psycho-bio-social beginnings and the environments and histories that have been in constant interaction with them.  We are glorious complexities, and should use medication only when there is little chance we can grow well without their (temporary) assistance.  They are never, for the reasons just cited, substitutes for the work and play of (inter)subjective development, nor have they been created by infallible minds and procedures.  Inform yourself about any psychotropic medications you take, but take this process seriously; consult with your psychiatrist, read studies published by the most stringent and prestigious journals, find out who funded the research in question.  Don’t fly off the handle because “the latest study” says this or that is okay or not okay. This takes work, but please; what’s more important than your (extended) mind/body, not just for you, but for the well-being of all?