Letter to Robert Whitaker

I wrote the following letter to Robert Whitaker, author of Anatomy of an Epidemic. 

Dear Mr. Whitaker,

I wanted to first of all thank you for your book. I read it when I was having a difficult time with my OCD symptoms and was considering taking antidepressants. Your book, along with a few others, convinced me otherwise. Given that these drugs appear to have dramatic side-effects, both short- and long-term, and aren't particularly effective, I am grateful that I did not go down that path. I am now doing significantly better.

Your book, as well as other books, advocate for a shift away from treating mental illness with drugs towards a therapy-based paradigm of care. While I wholeheartedly agree that drugs are not the answer, I also see many potential problems with a therapy-based paradigm. It seems to me that therapy is frequently advocated for, like drug-based care has been advocated for, without thorough analysis of it's dangers and benefits, as well as an thorough understanding of its philosophy towards treating mental illness.

If I may share my personal experience, my first foray into therapy was about 8 months ago. I didn't know I "had" OCD, all I knew at the time was that I was finding myself extremely anxious about strange things. My first therapist failed to accurately "diagnose" me and failed to offer any sort of effective treatment. I found myself getting worse over the few months that I saw her. My second therapist has been extremely helpful both in accurately assessing my "condition" and offering effective, science-based treatment. The caveat, however, is that he has repeatedly suggested medication for me to supplement his treatment, which I have refused.

My sense, from my limited experience, is that two problems can readily occur in therapy: First, therapists can fail to offer effective treatment as a result of not drawing upon the scientific data and tools that psychology research provides us. This can result in harm to the patient. And second, therapists can offer effective, science-based treatment. However, those most likely to offer science-based cognitive-behavioral treatment are also most likely to see drugs as playing an essential role in an effective treatment plan. I don't believe that the science-based psychology is functionally distinct from psychiatry--the two work together oftentimes to offer treatment in tandem. It is sometimes difficult to get good psychological treatment while refusing drug treatment, as it's easy for the therapist too see the patient as uncooperative or to see the refusal to take drugs as symptomatic of the underlying mental illness.

I was wondering if you had considered the difficultly of getting effective, science-based therapy while attempting to avoid psychiatric "care." I would be very curious to know anything that you've come across in your research or if you have seen anyone else explore this topic.

Thanks for a wonderful book,