"Studies May Overstate The Benefits of Talk Therapy For Depression"

[Dr. Richard Grossman]

Here's an interesting article from the NPR web site:

"Studies May Overstate The Benefits of Talk Therapy For Depression" by Jon Hamilton

http://www.npr.org/sections/health-shots/2015/09/30/444789771/studies-may-overstate-the-benefits-of-talk-therapy-for-depression

And this follows another study that said (from the same article):  "The finding comes several years after a similar study reached the same conclusion about antidepressant drugs."


All comments are welcome...

Richard

[Meh]

Reading... well there is money to be made off of drugs and running medical offices is my knee jerk reaction. And there is a demand.

"inflated by publication bias. This sort of bias occurs when studies finding that a treatment works are more likely to be published than those with a negative finding."  Hum this is sort of interesting, I had not thought of this before.

I think I went to a seminar/talk many many years ago that was given by that Celebrity doctor Drew from MTV who basically told people to "Take depression seriously and ask for help". Not sure why I am bringing that up it just pops into my mind for some reason.

I mean doctors and nurses just use the tools they have. What does a medical professional do if they have a common issue showing up. They have to offer something to people even if it doesn't work great.

Or maybe when the drugs were available the idea of depression was promoted even more to sell the product. IDK

Most of the therapy I went to I would say didn't help me when I was actively in the seeking-a-solution phase. I went to one therapy group where I said very little and just sat there listening but I found the hand outs were extremely informative, it was a grief group. It just made grief a valid thing. For me I hadn't really thought of it as being important and valid. For whatever reason I think of this as being the most helpful therapy I ever had. I went to one prior group that focused on depression and that group I hated and quit. There was also a lady that I saw one-on-one. I think I just wanted to talk to her to get a sense of normalcy when I was in a homeless shelter. I think it helped to conceptualize "the bigger better picture" that includes a concept of a future that was more normal. There is kind of a difference between being "I am a homeless person" which becomes a definition of self versus "I am a person experiencing homelessness" where its just an experience and not a self-description.

Part of the problem is a person is basically saying "I rarely ever feel happy/good anymore this sucks!!!!!... and then a therapist pushes some papers to them related to cognitive feedback and it feels like boring homework/doing taxes... and then afterwards its the same result "I rarely ever feel happy/good anymore this sucks"

I think I maybe sadly got to the point where I decided that people are not meant to be happy all the time, or most of the time. LOL Accepted reality finally.

If therapy is helpful I would say that it seems very subtle. I mean people believe in acupuncture and there is science to back it up I guess. Acupuncture is another thing that I think of as being subtle. Maybe therapy by it's very nature just isn't so splashy.

I think patients who are seeking treatment for depression are secretly hopeful or desperate for help.. not exactly "duly pessimistic"... but yah maybe also pessimistic. Maybe they are hopeful pessimists.

I would definitely think that therapy would be more helpful for things other than depression though. There is something about depression that I feel is hard to explain to people and hard for people to understand even if they are supposedly experts.

Last thought is that in my opinion I think depression has more to do with emotions/physical issues/loneliness than thought process. If therapy is directed towards re-training a person's thoughts or thinking patterns I think it's not getting to the core of it.

[Hopalong]

I think people need so much compassion.
We live in such an insane world.

If your heart is functioning, it's depressing.

Just having someone listen to you with compassion and a lot of love lets your courage come back. Some blows are vicious.

I know depression is a fog in the brain, and different from sorrow, but sometimes I think therapists over-focus on the clinical part and under-focus on the human absurdity and Meaning of It All questions...

Hops

[Meh]

If your heart is functioning, it's depressing.

OMG so true.

[Twoapenny]

Personally I feel that talk therapy quite literally saved my life, not in only in those awful 'I really want to kill myself' moments but in terms of helping me to escape all the horrible things that were pulling me down and rebuild a life that is healthier and more focused on me rather than me reacting to other people.  Things seem to go through phases like fashion, counselling seems to be changing and the talk therapy that I had doesn't seem to be around as much now; it seems to be more of a CBT type approach.  Whilst I felt that helped me to manage on a day to day basis it was the earth shattering moments of talking about abuse that had a really profound effect on me and - and I'm sure I've said this before - the two therapists I had were the first healthy people I'd ever really come into contact with.  I'd never experienced anyone having my best interests at heart; everyone in my life for many years was there for what they could get out of me and just having people who were genuinely concerned about my well being was enormously healing.  I genuinely feel very grateful to those two women for helping me to get my life going in a different direction.  They gave me some of the mothering I'd never had; that nurturing compassion that my mum just isn't able to do.  I still always remember the end of each session with one therapist (who was about the same age as my mum); she'd walk me to the door, open it for me and just give me a little rub on the shoulder as I left.  I always felt it was an incredibly mothering thing to do and the comfort it gave me was enormous.  So silly with such a small gesture but there was a reassurance and an acceptance in it, somehow, that I never got anywhere else.  Equally I've never found anti-depressants helpful yet know others who swear by them and who've found them very beneficial.  I suppose the thing is we are all very different and our desire to keep lumping people together and treating them all the same way just doesn't work

[Hopalong]

I'm sitting under (beside) my new SAD light (green one, as the white light began to bother my eyes) right now. Kind of like being in an aquarium.

I like it. And so far, even with gray chilly blustery wet outdoors...the winter depression seems not to be arriving.

It's from this company if anyone wants to try one. I got the single tower and it's really pleasant:
http://www.sunnexbiotech.com/

I did a ton of research and feel confident this is the best one around.

love
Hops

[sea storm]

Are you kidding me??? Talk therapy not very beneficial.   Some therapists are poor listeners and overzealous advice givers. But even they have clients.
It is only because medical science is so money oriented that they don't care or get it that traditional therapy is healing to people who have broken hearts.  Even science admits that.
I remember taking a week long course in Cognitive Therapy.  At the end of it one woman who worked for family services said that it sounded like a great program and one that could be used effectively with clients using computers. She was surprised when the rest of the group was shocked and dismayed by her comment. But I bet  a lot of people would see this as a chance to save dollars.

Oh .... has anyone noticed how depressed and disconnected people feel? They are starving for someone to talk to. I bet everyone who reads this is as well. I know I am.
I think some studies are so unhelpful.

[Hopalong]

Hear, hear.

I live alone.

My work is isolating.

I hate living alone.

Got to have a lot of time alone but day after day after day, esp in winter?

Thank heaven for my dog, whom I have profoundly confused with a human. She doesn't mind.

The lack of touch in my life disturbs my human equilibrium. People need several hugs a day to thrive. Sometimes I make myself go to church just to get a hug at coffee hour.

Ain't enough.

Hops

[Twoapenny]

Hear, hear.

I live alone.

My work is isolating.

I hate living alone.

Got to have a lot of time alone but day after day after day, esp in winter?

Thank heaven for my dog, whom I have profoundly confused with a human. She doesn't mind.

The lack of touch in my life disturbs my human equilibrium. People need several hugs a day to thrive. Sometimes I make myself go to church just to get a hug at coffee hour.

Ain't enough.

Hops

Aw Hops, that's exactly how I feel.  A friend I've not seen for two years rang yesterday, she was in the area visiting some other friends and would I like to go along?  I popped over, I know the two other friends of hers but not terribly well, it was just so nice, big hugs from everyone when we got there, they bent over backwards to welcome my son (who struggles with social situations), I was there for an hour just chatting and laughing and thinking wow, this is so nice, big hugs again when we left with one of them (who I don't know that well) saying it would be lovely to meet up again and telling me to call her.  Just lovely social interaction, healthy, fun, tactile, that hour did me more to lift my spirits than anything else has for such a long time.  We need to parcel these ladies up and despatch them for emergency hugging sessions, we do need it, don't we, it's like breathing, so necessary.

[sea storm]

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Re: "Studies May Overstate The Benefits of Talk Therapy For Depression"
« Reply #7 on: October 11, 2015, 12:06:25 PM »
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Hear, hear.

I live alone.

My work is isolating.

I hate living alone.

Got to have a lot of time alone but day after day after day, esp in winter?

Thank heaven for my dog, whom I have profoundly confused with a human. She doesn't mind.

The lack of touch in my life disturbs my human equilibrium. People need several hugs a day to thrive. Sometimes I make myself go to church just to get a hug at coffee hour.

Ain't enough.

Hops

I hear ya, Hops.
Being alone is like eating rust. Too much of being alone is a harsh diet.
Glad you have a dog, must get one. Sometimes, quite often, I am so lonely I could scream.
I keep going and try to be busy enough. There are times when I don't feel alone but it seems I have to work hard to have them.

LOTS OF LOVE,
sEA

[Hopalong]

Being alone is like eating rust.

Oh Sea, do you know what a poet you are?

If I could, I'd send you a gift certificate for a Poetry Writing course at your nearest pleasant educational institution.

The images and metaphors in your poems would be amazing.
And there'd be Japanese views.

Wow.

You need that impeccable, profound and lyrical voice to be heard.

SO happy to read you, always...

love to you, lots--
Hops

[sea storm]

Oh huff huff huff ... just swallowing the remnants of my last rust meal.  Ha Ha Ha.  It is good to laugh about loneliness and how crazy the world is. Thanks for that. I mean it. I need to scorn the beast at times.  So rarely is compassion offered and real listening. Dear Hops.

I think if you are lonely then things are very messed up in society.  "Ah Carl, we are all caught up in the total animal soup of time"(Ginsberg)

You may be interested to know that I am writing and holding those writings mighty close to my chest. I just read the play about the bookclub by Dr. Richard. He is not holding it close to his chest. I tried to print it so I can read it again.  It is hard not to slip into writing a dirge, but then I think oh write the dirge and then just edit all the fog and fire, charred bones out of it. That"s it. Just write.  I have lots of writing about different times in my life. Sailing to Japan and working for the elegant and corrupt Oya, taking the Eagle up north and working with the native fishery on the Nass River, Living on an island with no electricity or phone and fishing the coast, working as a teacher therapist at a Native treatment centre on an island where I had to take a boat every day for forty minutes ( every minute counted).     I definately have the spirit of just do it. All those adventures were beyond me and took all my courage, initiative, stick to it ness. The last big thing was the antique store selling Chinese and Japanese antiques. Like trying to warm a huge rock over a three year period. 
These have been lonely experiences where I was desperately trying to find meaning and escape the pain I feel inside. It is amazing that I didn't escape into drugs, given ample opportunity. I have a strong Buddhist Nun in me.

Thank you for your encouragement. It is so important. Bless you.

Love
SEa                                 

[sea storm]

Boy, that really bugs me. Talk therapy not helpful. I think you were waving the red flag at the bull with that one.

I think plays are talk therapy and I loved your plays!!!!! The bookclub one is funny and disturbing. Those guys are asking for trouble with their arrogant way of treating their guest with such arrogant detachment.  It is like they are out for blood because they are so bloodless and dead.
I wish the play went one for much longer. Riveting conversation.

Sea

[mudpuppy]

What the guy said who did the study was;

"Both talk therapy and antidepressant drugs "are efficacious," says Steven Hollon, a professor of psychology at Vanderbilt University and an author of the study, which was published Wednesday. "They're just not as efficacious as we think they are."

For each treatment, researchers found that the apparent effectiveness was inflated by publication bias. This sort of bias occurs when studies finding that a treatment works are more likely to be published than those with a negative finding."

That's not the same as not helpful and obviously some people benefit far more than others. In fact a thread like this can be a kind of publication bias in that people who have benefited a lot from talk therapy are a lot more likely to comment on it than others.


mud

[Dr. Richard Grossman]

Boy, that really bugs me. Talk therapy not helpful. I think you were waving the red flag at the bull with that one.

Sea

Hi Sea,

Actually, I posted the topic as something genuine to ponder!  My two talk therapies were destructive to me.  So, if I had had a talk therapy that was helpful (I didn't), the batting average of my therapists would  still have been .333--pretty good for Major League Baseball, but not so great as a treatment regimen (my apologies to readers who live outside of the U.S. and Japan for the metaphor!)

Therapy outcomes, IMO, depend highly on 1) the kind of human being the therapist is, 2) the kind of human being the patient is, (e.g., not personality disordered), 3) the match between therapist and patient, 4) the nature of the presenting problem, and other variables as well.  So, it doesn't surprise me that studies may overstate the benefits of talk therapy, not only for depression, but for other mental health issues as well.  Concerning the thread topic, depression treatment is also complicated by the fact that there often is a significant biological/genetic component--and talk therapy may or may not be able to "re-wire" the brain sufficiently to significantly reduce suffering.

On the other hand, I also know that "talk therapy" can change lives dramatically given the right combination of the above...

Richard

P.S.  

I think plays are talk therapy and I loved your plays!!!!! The bookclub one is funny and disturbing. Those guys are asking for trouble with their arrogant way of treating their guest with such arrogant detachment.  It is like they are out for blood because they are so bloodless and dead.
I wish the play went one for much longer. Riveting conversation.

Sea

Thanks!  I'm so glad you loved the plays!  The book club characters are so much like many of the people I met in the Harvard Medical School system.  While I have some beloved exceptions, doctors and academicians have become my least favorite groups of people at this stage of my life.  Writing about them is talk therapy for me, too!