Re:

To the editor:

Jonathan Alpert (4/22/12) presents a caricatured picture of long-term psychotherapies and trivializes the suffering of patients whose illnesses require more than an  'aggressive prod' to get them better.  Insight oriented therapy is not passive, but involves a kind of activity that encourages mobilization through self understanding - often by apprehending unconscious motivations. The effectiveness of this approach is supported by research (Leichsenring and Rabung).

He suggests that anxiety and depression are not severe psychological disorders compared to schizophrenia.  These mood states can be part of syndromes that are life threatening.  For example, Major Depression has a lifetime risk of suicide around 10% and Panic Disorder can be incapacitating.

While some patients may be in ineffective therapies, many more lament the inadequacy of their insurance coverage as it limits access to psychotherapy.  Others are encouraged to take medication because it is expedient rather than it necessarily being more effective.  The problem of the perennial patient pales in comparison to these contemporary problems.

Respectfully,

Larry S. Sandberg MD