The answer to anxiety can be better than antidepressants
John Crace criticises those who rail against the use of antidepressants (Thank you for the tablets, 8 April). But having spent more than 20 years as a psychotherapist, I've never come across anyone who believes there is no place at all for medication in the treatment of acute mental/emotional suffering. And no colleague has come close to saying "the worst thing that could happen to someone is to be prescribed antidepressants".
What I and other psychotherapists do question is our society's increasing reliance on drugs to deal with virtually any form of misery or distress. Not everyone is going through the kind of serious states of mind that Crace describes. One doesn't have to believe in any kind of conspiracy among doctors and "Big Pharma" to understand why hard-pressed GPs are handing out drugs to anxious and unhappy patients. Surely our response can be better than this?
Crace claims: "Few doctors prescribe antidepressants without pointing their patients in the direction of some kind of therapy as well." But often there are no services on offer. And it's just not true to say that psychotherapists "only have experience of mental illness at second hand". We are vulnerable human beings too, and many of us know from our own experience those frightening feelings that Crace describes so vividly. It is precisely these that have brought many of us into this work.
As for making "a living out of being professionally well": that living is, on the whole, modest and precarious. And often private work is all that is open to us. In this country there has never been anything like an adequately funded public therapy service, let alone a network of crisis centres, where people might have the time and space to look at the meaning of what they are going through – if that is what they want. Most therapists believe that people in distress ought to be given a choice, and there simply isn't one.
Crace says: "We don't need you [therapists] to tell us what we're supposed to think." But I am not interested in telling people what they should think. I'm interested in making a space where people can think for themselves, and come to terms with what life has thrown at them; in making possible a conversation where words like depression and stress and anxiety are a starting point, not a conclusive full-stop.
In the same way the therapeutic houses run by the Philadelphia Association for over 40 years have provided places where people in distress can find their own ways through suffering, in the context of a supportive and thoughtful community.
Psychotherapy – which means care of the soul – recognises the complexity of human emotion, and holds that there is always a meaning to suffering, whatever its nature, whatever its possible origins.
Behind every symptom and every appeal for medication is a story, and the silencing of those stories can be as much the cause of suffering as the details of the life itself.