By Catherine A. Sanderson, Amherst College
There are many different approaches to psychotherapy. Depending on the approach to therapy, the goals and methods of treatment are also likely to differ. Hence, we have drug therapy and electroconvulsive therapy (ECT) that adopt a completely different approach to treat psychological issues.
Psychotherapy in Pop Culture
Let’s start with a few fictional portrayals of psychotherapy on TV and in movies. In the television series The Sopranos, mobster Tony Soprano seeks therapy for panic attacks, while his therapist eventually confronts the ethics of, as it turns out, inadvertently helping a mobster be a better mobster.
In the film Good Will Hunting, an under-achieving intellectual prodigy, traumatized as a child, is challenged to overcome feelings of worthlessness and unlovability. And in the television series Crazy Ex-Girlfriend, a woman with borderline personality disorder seeks help from a therapist, who helps her find the right medication and introduces her to group therapy.
What these (and other) examples of psychotherapy in popular culture all share in common is a structured interaction between a trained professional and a client with a problem, and a focus on assessing, diagnosing, and treating some type of abnormal behavior. What they are missing out on is offering a comprehensive picture of psychotherapies that often take completely different course.
Alternatives to Psychotherapy
Therapy is especially beneficial for people who have relatively clear-cut problems: phobias, compulsions, depression. On the other hand, it tends to be harder to successfully treat more chronic and debilitating problems, such as schizophrenia or personality disorders.
Some people therefore pursue various alternatives to so-called talk therapy: the use of drugs as well as a couple of non-invasive medical procedures to treat psychological disorders.
This article comes directly from content in the video series Introduction to Psychology. Watch it now, on Wondrium.
Drug Therapy
Many people rely on some type of drug, or psychotropic, which can be very helpful at managing all sorts of disorders, including anxiety, depression, bipolar disorder, and schizophrenia. Basically, drugs work to reduce symptoms that can interfere with daily life functioning, like having trouble paying attention, or violent mood swings, or feeling too sad to get out of bed.
However, drugs are not an instant fix. Drugs take time to have their full effect, and sometimes tweaks in the dosage are necessary before they are most effective or to balance out various side effects.
There is also a real concern, among therapists as well as the general public, about overmedication, people taking unnecessary or excessive drugs, especially if they’ve failed to start with, or combine with, non-medical approaches that can be more effective, have fewer risks, and cost less.
Electroconvulsive Therapy
In some extreme cases, people may have tried psychotherapy and tried drug therapy, but continue to experience severe and highly disruptive symptoms. In this case, patients may be encouraged to try a procedure known as electroconvulsive therapy, or ECT.
This procedure—which used to be known as electroshock therapy—involves placing a patient under anesthesia and then delivering an electric current through the brain. This current triggers a widespread firing of neurons, basically brief seizures, which is believed to alter chemicals in the brain that influence mood.
ECT for Depression
This approach was first developed in 1938 and was used pretty commonly in the 1940s and ’50s to treat severe depression. Its use then declined, in part due to the potential for serious side effects such as memory loss, as well as the later development of drugs to treat depression and other serious psychological disorders.
Although it’s used far less commonly now than drug therapy, ECT is still used to treat depression, bipolar disorder, and some forms of schizophrenia when psychotherapy and psychotropic drugs have not helped.
Does ECT work? Yes, although it may result in both short-term and long-term memory problems. While there was once a lot of stigma attached, for severe depression, ECT can be life-saving for people who otherwise might be at risk of a suicide attempt.
Transcranial Magnetic Stimulation: Alternative to ECT
One alternative to ECT for depression and a variety of disorders, approved by the United States FDA in 2008, is transcranial magnetic stimulation, or TMS.
This procedure involves placing a small device containing a coil of wire directly on the skull, and then delivering electricity to stimulate neurons in the brain. Like ECT, TMS is designed to cause changes in levels of neurotransmitters, but TMS has tended to result in fewer side effects.
But for many people, drug therapy may be especially useful if combined with traditional forms of psychotherapy. One study found that for people who continued in talk therapy, only 25% of those who stopped taking anti-depressants relapsed to depression, as compared to 80% relapsing to depression for those who stopped taking meds without talk therapy.
Common Questions about Drug Therapy and ECT
Drug therapy is an alternative to psychotherapy where people rely on some type of drug, or psychotropic, which can be very helpful at managing all sorts of disorders, including anxiety, depression, bipolar disorder, and schizophrenia.
The electroconvulsive therapy (ECT), also known as electroshock therapy, involves placing a patient under anesthesia and then delivering an electric current through the brain. This current triggers a widespread firing of neurons, basically brief seizures, which is believed to alter chemicals in the brain that influence mood. This approach was first developed in 1938 and was used pretty commonly in the 1940s and ’50s to treat severe depression.
Transcranial magnetic stimulation (TMS) is an alternative to ECT. This procedure involves placing a small device containing a coil of wire directly on the skull, and then delivering electricity to stimulate neurons in the brain. The stimulation is designed to cause changes in levels of neurotransmitters, but TMS has tended to result in fewer side effects.
