I think this issue is currently under debate; I have just glosse

In a nutshell, all forms of talk therapy (psychoanalysis, CBT, etc) have roughly the same effectiveness, regardless of theoretical basis.
posted by nasreddin at 8:05 PM on February 3, 2008 [2 favorites]

You have an incomplete (at best) understanding of the state of outcome research in psychotherapy. If you're interested, you should read Bruce Wampold (The Great Psychotherapy Debate) or Michael Lambert. Both demonstrate that, in fact, in addition to psychotherapy working very well (an average effect size of 0.80) it also works through non-specific means. What this means in practice is that all forms of psychotherapy (including psychoanalysis) work about equally well. There are, indeed, some differences in what and how things are addressed in different treatment modalities, but those differences are often precisely what draws some people to different forms of therapy. Some people may find that a model that privileges conscious thoughts makes the most sense for them, others may find that one that focuses on childhood experiences and fantasy works best for them. Since they both work the same, and we don't live in a society where treatment decisions are mandated by fiat, people are free to make their own choice about how to spend their time and money.

So, as a treatment, you're incorrect. Psychoanalysis works, as do most psychotherapies, quite well at relieving patient distress. The question of the precisely Freudian model of the mind is a more nuanced one, but there, too, I think you're mis-informed. If one takes the Freudian model as a precise description, then it's bound to fail. However, there is plenty of evidence from neuroscience that the broad outlines are not so far off. We know, for instance, that most of the mind's activities take place below the level of consciousness. We know memory functions associatively, we know that feelings and memories and body states are all linked. Those are all Freudian notions, too. I always find it interesting that no one suggests that CBT should be abandoned because the model of the mind it proposes is somehow bankrupt, and yet, at the same time, no one is willing to argue that CBT works because it accurately describe how the mind works. This is because both CBT and psychoanalysis are primarily treatments, and their usefulness is predicated on how well they accord with how people experience their mental lives. The fact is that many many people find the concepts advanced by psychoanalysis to be persuasive.

You also appear to be operating under a mis-perception about the state of current knowledge about mental illness in general, and in psychiatry. There are currently no physiological tests for mental illness, and the medicalized treatments that we have for mental illnesses are not really all that much better than placebos in many many cases. That's when we can get people to take the meds in the face of crushing side-effects. The notion that mental illness or distress is biological in origin is just a notion, not currently borne out by the research, and the consistently confirmed effectiveness of psychotherapy suggests that a medical model is probably a poor way to conceive of these illnesses. That there is an ongoing debate about the causes and proper treatments for mental disorders is completely consistent with the state of the science, despite what advertisements from pharmaceutical companies would lead one to believe.

This recent FPP has a bunch of links from both sides of the issue, although on the question of the state of the science you might be most interested in the second link of the FPP on the problems with the serotonin hypothesis.
posted by OmieWise at 8:06 PM on February 3, 2008 [30 favorites]

所有跟帖： 

• 除了学psychoanalysis的人，其他人没觉得有啥可debate的。另，他们现在也开药了，因为光说不够用。 -Kamioka- ♀ (0 bytes) () 01/17/2013 postreply 19:41:27

• All models are wrong, some are useful -SwiperTheFox- ♂ (0 bytes) () 01/17/2013 postreply 19:43:19