R*******@aol.com wrote: Dear Dr. Baughman: I fully agreed with your commentary on the Time Magazine article on anxiety. It really is like an infomercial isn't it? I particularly liked when you said that they seem to have a rule that they can't say anything nonbiological about a nonbiological problem. What this research really amounts to is looking for biological correlates of normal fear and then making unwarranted speculations about biological abnormalities. This is like taking a baseball player who is in a slump and examining the anatomy of the normal arm and then speculating that non-existent anatomical abnormalities in these structures must be causing his slump. And notice how even though their unvalidated biological speculations may greatly vary (amygdala, hippocampus, frontal cortex) the treatment they recommend is almost always the same: SSRI antidepressants. This seems clearly to be a case of fitting the problem to the treatment rather than fitting the treatment to the problem. This is the one "treatment" that they have, so they try and create a rationale for using it for practically every imaginable human problem. And they do this as you say by creating the illusion of biological abnormalities usually in the form of a "biochemical imbalance" to create a rationale for using drugs. As far as anxiety you are right. There is always a reason. People are always anxious about something, and it always makes sense given the context of their life and their past experiences. There is no such thing as the brain simply creating anxiety for no reason except in the case of some rare medical conditions which have a truly demonstrable biological pathology. What they failed to mention in this article is the one thing of greatest importance, which is that in the case of anxiety problems there is a very large body of treatment outcome literature all published in professional journals including medical journals which shows consistently that psychological therapy, particularly cognitive-behavior therapy, is far more effective than medications (and of course is far safer). There are studies for example showing success rates for people with panic attacks as high as 90% (and even 100% in one study published in the Journal of Mental and Nervous Disease). These results are very durable (85-100% of people panic free at one year follow-up), and this is all achieved typically within 8 therapy sessions. Across the board all the research with anxiety problems shows consistently that only cognitive-behavior therapy has truly lasting results while of course being free of risks and side effects. Time Magazine could have done its readers a real service by informing them about this most effective and safest therapy for anxiety problems rather than lending support to all of this nonsense about imaginary biological abnormalities. And it would seem to be the responsibility of all practitioners to inform people suffering from anxiety as to what is the best and safest therapy available as determined by empirical studies rather than telling them they have imaginary biochemical imbalances and prescribing drugs. It is not an exaggeration to say that there are thousands of people who could completely overcome an anxiety problem in a few sessions who are instead put on drugs for years or even life, because they are never informed that this therapy exists. This would be similar to not giving people with bacterial infections information about antibiotics, and giving them instead a far inferior and riskier "treatment," because that just happens to be what the practitioner does. And on top of this they actually benefit from the ineffectiveness of their "treatment," since they now often have a patient for years or for life. Sincerely, Roger Tilton, Ph.D. (Dr. Baughman, a couple more comments. They get around the inferior effectiveness of drugs by clever semantics. They artificially divide symptom relief and relapse rates and call symptom relief "effectiveness" while rarely even mentioning relapse rates. In this way a treatment in which 100% of people relapsed when taken off a drug would be considered as "effective" as a treatment where 0% relapsed that is where 100% are permanently cured! .........The only thing of merit mentioned in the Time article was the Kendler study which I am aware of. Kendler sees a genetic contribution on a normal dimension such as what we call anxiety sensitivity which interacts with experience. This has absolutely nothing whatsoever to do with a genetic abnormality or any kind of "genetic determinism" which of course is another one of the illusions which they try to promote.) |