“Heated Critique” or debates on controversial issues often get mixed up with facts, opinions, and personal faith based beliefs, associated with heightened emotions that are often difficult to sort for rational discourse, as people tend gravitate from one dimension to another.
As I have posted here many times, brain and behavior are two sides of the same coin, different discipline training require emphasis of different perspective, not necessarily negating one over the other. Based on individual needs, we need both perspective involvements based on individual circumstances and needs. It is when over use of one over the other, in the context of promoting one, without objective outcome assessment becomes problematical, and that goes, I believe, for both medication and or psycho-social interventions.
As a psychologist, I have collaborated with psychiatrists in clinical practice and have been in many collaborative research work or publications. In spite of my psychology background and preference for psychotherapy over medication intervention, when my own cousin got severely depressed with psychosis following a successful professional career after retirement, and did not respond to standard psychiatric treatment on outpatient and inpatient basis, and he was functioning at a very “disabled,” level, and in spite of my knowledge of his complicated life history, I did not suggest him and the family to pursue psychotherapy in conjunction with all the medication treatment he was receiving. instead I advocated strongly to him and to his family for a trial of ECT, which he and the family followed through. Eventually, not only he recovered completely, he decided to go off all medications and maintenance ECT against medical advice, and is now maintaining the highest level of functioning possible for his age (e.g., playing tennis, starting his own consultation service, etc.) without any medication, ECT, or counseling services for almost 5 years. I arranged to have him present his case to NE ISPS meeting, and subsequently in collaboration with several ISPS members, we published a case report to highlight the importance for consideration for maintenance of recovery with natural support following successful outcome with “treatment.”
Again, this is a case by case issue, and must be considered in the context of each individual unique personality and present life circumstances, and what has worked and not worked.
The point I am making is that there are different avenues to recovery and management process, where a combination of biological and psychosocial interventions to a varying degree may be needed. Over dependence or over-reliance on one or both beyond ones’ needs may impact recovery and self-autonomy, both of which are interconnected, and reliance of any modality may have iatrogenic or unwanted consequences.
In a field, such as mental health, we often pretend or claim to know a lot, but in actuality may not know a lot, and that goes both for biological interventionist and psychosocial interventionists. It is better to have an open mind and evaluate outcome effects objectively, in the context of our present knowledge, which continues to be a dynamic and fluid. That’s why an open dialogue airing different perspectives is so helpful.