Psychotherapy
Myrna Weissman, Ph.D.
How would you define psychotherapy?
There are many kinds of psychotherapy. In general, it is a talk between the
patient and the therapist. But it is not just random talk. There is a theoretical
basis and a protocol that the therapist follows. During therapy, patients
should have a trusting relationship with their therapists so that they can
discuss anything that they want. Patients need to know that the talks are
confidential and they won't be chastised. That way, they can honestly evaluate
what is going on without blame.
What is interpersonal psychotherapy?
In the 1970s my late husband, Gerald Klerman, developed various studies to
test out the best maintenance treatment for major depression. He set out to
develop a psychotherapy that would be time limited, specified in a manual,
and could be tested the same way drugs are tested. The result is interpersonal
psychotherapy.
The idea behind interpersonal psychotherapy is not to cure major depression,
but to understand the relationship between the onset of depression and what
is going on in the patient's life at the time the symptoms emerged. This analysis
provides an understanding of the environmental triggers so that the patient
can better deal with those factors.
There are other structured psychotherapies that have been tested that are
good, especially cognitive behavioral therapy. Both interpersonal psychotherapy
and cognitive therapy have been tested in clinical trials and specified in
a manual.
How effective is psychotherapy in comparison to
medication?
There was a study published by Chuck Reynolds that showed that the combination
of medication and psychotherapy is better than either alone for major depression.
One of our studies showed that the combination is better than either treatment
alone. Psychotherapy and medication have different outcomes. Medications more
rapidly affect the symptoms. Patients sleep and eat better quickly on medication.
Psychotherapy usually takes longer.
What types of questions should one ask about psychotherapy?
You should ask your therapist what type of psychotherapy is being used, how
long will it last, and what you can expect (what will your therapist cover).
What will your therapist do if the psychotherapy doesn't work and how will
your therapist know it is not working? For example, if by the end of ten to
twelve weeks, you don't have some reduction in your symptoms (e.g., eating
or sleeping better), what will your therapist recommend?
© 2001 Families for Depression Awareness
