Last week I wrote about post-traumatic stress disorder (PTSD). I quoted research showing that the cure – and even the preventative – may be found in relationships. This is a basic fact well known in my field but it gets lost in the public and insurance company clamor for quicker fixes – medication, or simplistic approaches such as “exposure therapy” wherein you have someone think about or in some more active way re-live their trauma.
Well, I found more data. A few months ago, the American Journal of Psychiatry published a study comparing relaxation therapy, interpersonal psychotherapy, and the “gold standard” PTSD treatment – exposure therapy in its various forms, including as used in Cognitive Behavioral Therapy. Turns out an interpersonal approach – what the world thinks of as rather traditional psychotherapy – works as well, as fast, as by some measures better than exposure therapy.
Furthermore: 1) There was lower attrition – fewer people dropping out of treatment – with interpersonal psychotherapy as compared with the treatment that included exposure therapy. 2) patients who were also depressed – as many with PTSD are – were nine time as likely to drop out of exposure treatment as compared with interpersonal psychotherapy. 3) Both exposure therapy and interpersonal psychotherapy produced better results – more symptom relief – than did simple relaxation therapy.
(You can read an abstract of the journal article – or pay a fee and read the whole thing – here: http://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2014.14070908.)
And what’s this got to do with my book?
1) Interpersonal psychotherapy is probably the closest to what I (and many others) do. It works, and here’s some research confirming that. And let’s be clear what they mean by “Interpersonal psychotherapy”: Writing about the study in the New York Times, John Friedman, professor of clinical psychiatry at Weill Cornell Medical College in New York City, describes it as “a treatment which focuses on patients’ emotional responses to interpersonal relationships and helps them to solve problems and improve these relationships”. Yet this mushy-sounding, emotion-focused, sit-on-a-couch-and-talk treatment did the job.
2) It would be wonderful if, as more often has happened in medicine, new discoveries revolutionized psychological treatments, but this just doesn’t happen much. So many of the new treatments I’ve studied over the years turned out upon closer scrutiny to be glorification of treatment components many of us, sometimes even a hundred years ago, were already using in our work. Cognitive-behavioral techniques and concepts, for example, were around long ago, but it’s only in the past 40 years or so that it has been elevated into a new kind of therapy, complete with new terminology for mostly old ideas. People call and ask “Do you do Cognitive Behavior Therapy”. The answer is yes, and I do a lot more. So do most of the competent therapists I know.