Re: "Successful and Schizophrenic" — Letters that should have been in the new york times

To the editor:

Elyn Saks (Successful and Schizophrenic, 1/27/13) does the public a great service by highlighting her capacity to live a full life with a severe psychiatric illness rather than be defined by it. Her story is familiar to those of us who treat this and other serious illnesses like schizoaffective illness or bipolar illness. Of particular relevance is her unabashed acknowledgement that 'excellent psychoanalytic treatment' has been critically important. An examination of national trends in office-based psychotherapy by psychiatrists (2004 - 2005) found that only 10.8% of psychiatrists provide psychotherapy and the number is probably lower now. As pressures grow on the practicing psychiatrist to limit cost and to document 'medical necessity' (no doubt more easily done with medication than psychotherapy) there is a real danger that the talking cure will be lost as part of the psychiatrist's armamentarium.

Respectfully,

Larry S Sandberg MD