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NOTE: THIS ARTICLE WAS ORIGINALLY PUBLISHED IN BINAH MAGAZINE'S COLUMN THERAPY: A SNEAK PEEK INSIDE
Look, the only thing I can do is give you straight talk from the perspective of a therapist. I refuse to give you medical advice. I refuse to make the decision for you. I refuse to convince you one way or another whether or not to fill your prescription for Lexapro, Xanax, Wellbutrin, or Clonepine. I absolutely refuse. And here's why.
Little history lesson first.
It used to be that psychiatric wards were filled with lunatics. There were asylums jam packed to the gills with crazies. The conditions were awful and the prognosis even more so. Mental illness was nothing short of a death sentence, the chances for normal life virtually zero.
And then came the reforms. Do-gooders, Good Samaritans went into these places and demanded that people with mental illness be treated humanely. And that definitely helped. Especially after one brave journalist wrote a powerful expose on life in one of these places. So now the wards were cleaner, nicer, and the inmates treated more decently. But the people were still considered crazy; they still acted crazy.
Today, those places are mostly gone. No need for 'em anymore.
Well, what happened to all those people?
They escaped.
How, you ask?
With the miraculous onset of psychotropic drugs.
We live in a world where drugs can alleviate a variety of symptoms of mental illness so that once-crippling diagnosis have changed to allow for an optimistic prognosis for normal life.
People with bi-polar (originally called manic-depressive) disorder have the miracle drug lithium which stabilizes them and allows them to lead functional lives in the comfort of mainstream society. The same goes for severe OCD, Tourette's Syndrome, and a host of other mental illnesses which can be managed with a variety of psychotropic drugs.
Psychotropic drugs have almost single-handedly changed the way we view and live with mental illness.
Our little history lesson over.
Here's the essay question: What is the moral of the story? (I know, in history you need to write essays about how it repeats itself and morals are for literature classes. Oh well, I'm the writer here, so I can give whatever test I choose.)
Moral? Sometimes you should definitely say yes to drugs.
Sometimes I get clients who are struggling so hard to improve their lives, fighting anxiety or depression, putting in Herculean efforts to change; and with a pill, the fight becomes easier and life becomes more productive. I cheer on my clients who fight the good fight of mental illness with a combination of therapy and drugs.
But.
But, but, but.
There's been an explosion of prescribed drugs for people who simply don't want to tolerate any feelings of discomfort.
Shidduchim is stressful? Suffering from insomnia? Complicated career choices? Take a pill.
Moving to a new house? Your daughter just had triplets? Pesach is coming up? Pop a pill.
Mother-in-law problems? Lost your job? Child refuses to be potty-trained? Gulp down that pill.
I tell my clients, “Anxiety is a good thing. It's what motivates you to achieve. You just need to get that anxiety down to a level that it works for you, not against you.”
When a new client comes into my office with anxiety and immediately asks about taking medication, I say, “Why don't you wait two or three sessions? Once you realize that your anxiety level can be decreased with just therapy, you can make a more informed decision at that time.”
I feel my role as a therapist is not only to help a client overcome the challenge that originally brought her to therapy, but to give her the tools to accept her anxiety as a strength and to learn how to manage it across many situations.
Using drugs to dull the anxiety robs a person of the chance to grow from the experience of that particular challenge because the entire challenge has been dulled.
When a person comes to therapy, even as an adjunct to taking drugs, at least he is working on the problem itself on some level. But many people avoid the anxious feelings, avoid the problems that provoke those anxious feelings, and avoid those messages behind the anxiety by reaching for the pill bottle. Therapy is way harder than taking a pill. Way more time-consuming, painful, and challenging.
With that pill, you are no longer stressed that you lost your job. Great. But you have also lost the ability or motivation to figure out why you were fired and to make constructive changes that will improve your quality of life.
This new refusal to sit with our pain, to sit with our discomfort, to sit with our feelings that may not always be pleasant is also a refusal to grow as people.
A client suffering from anxiety walked into my office (Yes, she gave me permission to repeat this anecdote. Confidentiality, confidentiality, confidentiality!).
I explained to her how cognitive behavioral therapy (CBT) will work to alleviate her symptoms.
“Do I have to believe in this for it to work?” she asked me suspiciously, as if I was selling her some hocus pocus that needed her to believe in fairies for the magic to manifest itself.
I laughed. “No,” I said. “If you do the work, it's going to help even if you don't believe it will.”
And it did.
Bring on the angry comments!
My book, Therapy, Shmerapy, can be found in bookstores or online