Family Therapy as an Alternative to Medication: An Appraisal of Pharmland

350 Pages·2003·4.74 MB·English

by  Phoebe Prosky

FAMILY THERAPY AS AN
ALTERNATIVE TO MEDICATION
FAMILY THERAPY AS AN
ALTERNATIVE TO
MEDICATION:
AN APPRAISAL OF
PHARMLAND
Phoebe S.Prosky, MSW and David V.Keith,
MD, Editors
BRUNNER-ROUTLEDGE
NEW YORK AND HOVE
Published in 2003 by Brunner-Routledge 29 West 35th Street New York, NY
10001 www.brunner-routledge.com
Published in Great Britain by Brunner-Routledge 27 Church Road Hove, East
Sussex BN3 2FA www.brunner-routledge.co.uk
Copyright © 2003 by Taylor-Francis Books, Inc.
Brunner-Routledge is an imprint of the Taylor & Francis Group.
This edition published in the Taylor & Francis e-Library, 2005.
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“When My Sorrow Was Born,” from The Madman, by Kahlil Gibran, is reprinted
with permission from Dover Publications © copyright 2001.
Cover design by Mark Lerner
Cover photo © Corbis
All rights reserved. No part of this book may be reprinted or reproduced or utilized
in any form or by any electronic, mechanical, or other means, now known or
hereafter invented, including photocopying and recording, or in any information
storage or retrieval system, without permission in writing from the publishers.
Every effort has been made to contact copyright holders of papers reprinted in this
book. If any have been inadvertently overlooked, the publisher will be pleased to
make restitution at the earliest opportunity.
Library of Congress Cataloging-in-Publication Data
Prosky, Phoebe.
Family therapy as an alternative to medication : an appraisal
of pharmland / Phoebe Prosky and David Keith.
p. cm.
Includes bibliographical references and index.
ISBN 0-415-93398-6 (Print Edition) (hardcover)
1. Family therapy. 2. Mental illness—Chemotherapy. 3.
Psychotherapy.
[DNLM: 1. Family Therapy—methods. 2. Mental Disorders—
drug therapy. 3. Psychotherapy—methods. WM 430.5.F2 P966f 2002]
I. Keith, David V. II. Title. RC488.5 .P75 2002
616.89'156–dc21
2002014093
ISBN 0-203-48377-4 Master e-book ISBN
ISBN 0-203-57530-X (Adobe eReader Format)
Dedication
We would like to dedicate our book to three people
who were, and continue to be, guiding spirits in our
work, practitioners whose careers were characterized
by a spirit of exploration and steady attention to
human growth and the deepening of experience in
therapeutic work with families: Nathan
W.Ackerman, M.D., Edgar H. (Dick) Auerswald,
M.D., and Carl A.Whitaker, M.D.
Contents
Acknowledgments viii
Introduction ix
Part 1: Introduction: Setting the Stage for an Exploration of the 1
Interface of Family Therapy and Medication
1. Biometaphorical Psychiatry: Family Therapy and the 3
Poetics of Experience
David V.keith, MD
2. When More Is Less: A Common Difficulty in 25
Collaborative Treatment of Human Distress
Phoebe S.Prosky, MSW
Foreword to Chapter 3 35
3. Family Healing and Planetary Healing: Three Paradigms 37
in Search of a Culture
Edgar H.Auerswald, MD
Part 2: Theoretical Dimensions: Dilemmas and Contradictions in the 61
Approaches of Family Systems Therapy and
Psychopharmacological Practice
Introduction to Part 2 63
4. Psychobiological Family Therapy: Toward an Ecological 67
Psychiatry
Larry Freeman, MD
5. A Systemic Frame for Mental Health Practices 93
Marcelo Pakman, MD
6. Can Giving Heal? Contextual Therapy and Biological 111
Psychiatry
Catherine Ducommun-Nagy, MD
7. Medicating the Ghost in the Machine 139
vi
Paul Schaefer, MD
8. Rethinking Illness 159
Zhao Mei, MD
Part 3: Political lssues:The Mechanisms Behind the Accelerating 167
Growth of Psychopharmacological Practices
Introduction to Part 3 169
9. The Myth of the Magic Pill 171
Barry Duncan, PsyD, Scott Miller, PhD, Jacqueline
Sparks, MS
10. Pig Pharma: Psychiatric Agenda Setting by Drug 193
Companies
Sharon Beder, PhD, MSCSoc, Richard Gosden, PhD,
and Loren Mosher, MD
Part 4: Seeking Health: Clients Describe Their Experiences with 211
Family Therapy and Psychopharmacological Treatment
Introduction to Part 4 213
11. The Headache 219
Patricia Dyer, MSW
12. Love of a Lifetime 225
Noralyn Masselink, PhD
13. The Therapy That Almost Wasn’t, or Imaginary Therapy 243
Oscar Davis
14. The Therapist Replies: Observations from the Therapist 251
Who Didn’t Do Anything in the Therapy That Almost
Wasn’t While Attempting to Salvage the Love of a
Lifetime
David V.Keith, MD
An Afterword to the Client Essays 257
Part 5: Clinical Illustrations: Systems-Based Practices as Alternatives 259
to the Use of Medication
Introduction to Part 5 261
15. Expert Therapist—BeginningTherapist 265
John Flynn, PhD, MSW and Phoebe S.prosky, MSW
16. The Jazz Consultation: Improvisation in Family Therapy 271
vii
Amy Begel, MSW, and David V.Keith, MD
17. Goldilocks and the Three Bears Revisited 283
Fred Ford, MD
18. My Journey with Allison in Wonderland 285
John M.Benda, LCSW
19. Deficit of Attention Disorder 297
Felix Yaroshevsky, MD, CRCPC, and Vivian Bakiaris
20. Thinking about Thinking in Family Therapy 303
Edgar H.Auerswald, MD
Afterword 319
Contributors 321
Index 325
Acknowledgments
The editors acknowledge with great appreciation the contributions of
people whose generosity helped to make this book possible. Patricia Dyer
shared her editorial insightfulness, created two of the images for the book,
and provided invaluable technical assistance in preparing the manuscript
for the publisher; her patience throughout the process of the work on this
book is greatly appreciated. Noel Keith provided help with sampling and
shaping ideas, along with an abundance of encouragement and inspiration
when needed. Sarah Auerswald assisted in gaining the permission to
republish two of her father’s papers in this volume. Barbara Anthonson
contributed generously of her time and computer knowledgeability in
helping to ready the manuscript for publication. Editor George Zimmar,
Assistant Editors Shannon Vargo and Luciana Cassano, and Production
Editor Richard Rothschild did a superior job of editing our work and
supporting us through its production. We wish to thank Mr. Zimmar and
the staff at Brunner-Routledge for being willing to take on the publication
of this book in light of its counter-cultural bent.
Introduction
“All right,” said the Cat; and this time it vanished quite slowly,
beginning with the end of the tail, and ending with the grin, which
remained some time after the rest of it had gone. “Well! I’ve often
seen a cat without a grin,” thought Alice; “but a grin without a cat!
It’s the most curious thing I ever saw in all my life!
Lewis Carroll, Alice’s Adventures in Wonderland
This book explores the interface between two different ways of thinking
about the world of mental health: family systems-based therapy and
modern “biological” psychiatry. Biological psychiatry, with its
armamentarium of medications, has largely eclipsed the family systems or
ecosystemic model of psychotherapy, which has as its focus context and
relationships. Routinely patients are being placed on medication in
response to emotional or mental symptoms, not only by psychiatrists, but
also by physicians in all specialties, often on the recommendation of
nonmedical therapists and teachers. This rush to medicate, with its side
effects of dependency and the redefinition of experience as disease, has
begun to draw the skepticism of practitioners and a public that senses its
possible costs as well as the importance of arriving at self-mastery in life.
The powerful potential of the ecosystemic approach of family systems
therapy, so much in tune with larger ecological concerns today, responds to
this situation. In the 50 years since the ecosystemic approach began to be
articulated, its usefulness has become overwhelmingly evident, yet its
potential has barely begun to be mined. We are developing this book in an
attempt to awaken broader awareness of the vision of systems-oriented
psychotherapy in hopes of keeping it from being disappeared by the strong
forces of the medical profession and the pharmaceutical industry.
Our book acknowledges the usefulness of medication, but expresses
skepticism about the way the medication model has been embraced by
practitioners and patients. Our skepticism is based on our experience in
working with families as systems in which psychiatric medications are often
irrelevant and sometimes harmful. Both editors have practiced and taught