cross posted from Dennie's Blog

So rang out a headline on the front page of the New York Times, followed by a full page story. What was talk? And why didn't it pay? As it unfolded, the exposé concerned the shift from what we once knew as psychotherapy—"talking therapy"—to medications. 

This new direction has come about over the past few decades largely due to changing times as we have become more impatient and accustomed to quick fixes—with no pain!  And accelerated by inflation—in our current economic framework, psychotherapy is no longer cost effective. While insurance companies might pay $90 for a 45 minute session of talk therapy, they will reimburse a shrink $150 for 3 sessions of 15 minutes each. The Times' article focuses on one psychiatrist who typically works an 11 hour day seeing as many as 40 patients in one day, in contrast to a psychotherapist who may see seven or eight. (Average annual salary for psychiatrists, $191,000 in 2009). Other talk professionals, such as social workers and clinical psychologists (except neuropsychologists who can prescribe medications) are restricted as to the amount insurance companies will compensate. 

Perhaps I have it wrong. My take has long been that many of the difficulties we humans face have to do with getting along with ourselves and with others. Beginning early in life, and perhaps even before that crucial event, we develop a variety of means to survive and manage. Some methods are effective. We add to, modify, and delete from our repertory of behavior. But, for some, there are situations beyond their coping ability. Here's where the  talking therapies come in. We've run the gauntlet from hypnosis, to psychoanalysis, group therapy, behaviorism, and the many variations. I had the opportunity for a classical psychoanalysis early in my life and then I practiced individual and group psychotherapy in a variety of situations—before the drug upsurge. I don't negate the judicial use of medications—for some conditions there seems no alternative. But it's the across-the-board use that concerns me.

Maybe I'm off beam again and trying to cope with a world that has passed me by. Perchance the talking therapies have had their day and are no longer fitting. Which raises more speculations than remedies. Is psychotherapy no longer essential?  With instant communication, online identity, electronic interaction, and all the possibilities which the new technologies assure, is the psyche itself entering into a new phase of development? Carl Jung wrote: “We are living in what the Greeks called Kaipos—the right time—for a metamorphosis of the gods. . . The peculiarity of our time, which is certainly not of our conscious choosing, is the expression of the unconscious man within us who is changing.”

 Could the new technologies enhance that creation—or will they, like medications, become yet another palliative?