Beyond Blue

Beyond Blue

Kay Redfield Jamison on Psychotherapy

I often wonder what it is, exactly, about psychotherapy that is so crucial to my recovery. I wish I only had to go to the self-help section of a bookstore or sit down for coffee at a friend’s house to experience the kind of inner cleansing that I do at therapy. I wish there were an easier way. Because good counseling requires time, money, and heartache.
The best passage I’ve ever read about the twin powers of medication and psychotherapy together–the words that have come closest to explaining why I need them both even as I don’t want either–is from Kay Redfield Jamison’s memoir, “An Unquiet Mind“:

At this point in my existence, I cannot imagine leading a normal life without both taking lithium and having had the benefits of psychotherapy. Lithium prevents my seductive but disastrous highs, diminishes my depressions, clears out the wool and webbing from my disordered thinking, slows me down, gentles me out, keeps me from ruining my career and relationships, keeps me out of a hospital, alive, and makes psychotherapy possible. But, ineffably, psychotherapy heals. It makes some sense of the confusion, reins in the terrifying thoughts and feelings, returns some control and hope and possibility of learning from it all. Pills cannot, do not, ease one back into reality; they only bring one back headlong, careening, and faster than can be endured at times. Psychotherapy is a sanctuary; it is a battleground; it is a place I have been psychotic, neurotic, elated, confused, and despairing beyond belief. But, always, it is where I have believed–or have learned to believe–that I might someday be able to contend with all of this.
No pill can help me deal with the problem of not wanting to take pills; likewise, no amount of psychotherapy alone can prevent my manias and depressions. I need both. It is an odd thing, owing life to pills, one’s own quirks and tenacities, and this unique, strange, and ultimately profound relationship called psychotherapy.

  • Elizabeth

    Wow. Well said. I am learning about the power of both right now.
    I tried just taking my meds but I learned that the thoughts still had way too much power over me so now I have started therapy and though I get nervous on my way to my therapy appointments and feel exhausted afterwards……
    I AM getting better thanks to the combo of both meds and therapy!

  • Teri A

    I cannot begin to tell you the benefits of psychotherapy in conjuction with the right medications! If I had just been doing psychotherapy in which I had tried, and went through so many times, without the benefits of medication–what they were asking of me–the changes I had to make within myself would have (and were) impossible. My brain chemistry was just off–and I would leave with a sense of, “Yeah, yeah, it all sounds good…” But how can you possibly leave your brain chemistry alone and instigate all the changes YOU WANT to have in your life, but just can’t see a way out of the black hole of depression. It was only after I had the right medication prescribed for me, that my brain began to operate positively. I could see the advantages for me–all the way from my self esteem, to establishing healthy borders, to making goals for myself, and my way out of the “black hole” of depression. Have been doing well for 5 years now–happy to report. And if I have to be on these medications for the rest of my life-oh well–at least I’ll be living a happy life. Right now, my boyfriend of 3 years, has to search for a job about 600 miles away, and it’s not crushing me, like me like other relationships have. I know I’m strong enough to stand on my 2 feet and won’t “die” if he has to leave. I’m DEALING with it. Not to say I don’t feel pain, but it’s not overwhelming my whole life. I know I have a start on a new career, and my own life to live, just as he does. It will just be a time of sorrow and of loss when and if he has to move. It won’t crush me into insanity, like the last relationship did–where I had to be hospitalized 3 times. Dealing with life issues, sounds by other people to be so easy–but when your brain chemistry if off–it’s nearly impossible.
    Best wishes to everyone to find the right therapist and if needed the right medications. I believe God gave men the power and knowledge to create these types of medications, knowing that we would live in these times of constant fight or flight modes, and sometimes some of us just can’t cope. I hope someone finds this helpful.

  • Meg

    One of my favorite passages (although I have many) from “An Unquiet Mind” is:
    “The debt I owe my psychiatrist is beyond description. I remember sitting in his office a hundred times during those grim months and each time thinking, what on earth can he say that will make me feel better or keep me alive? Well, there was never anything he could say, that’s the funny thing. It was all the stupid, desperately optimistic, condescending things he DIDN’T say that kept me alive; all the compassion and warmth I felt from him that could not have been said; all the intelligence, competence, and time he put into it; and his granite belief that mine was a life worth living.”
    I have to agree. Without psychotherapy, life would be much more difficult to manage. I am indebted to my therapist, to the combination of therapists I’ve had over the course of my life, each one playing their own significant part in my recovery. Thanks for the post, Therese!

  • Lynn Dover

    I had given up hope that there was a treatment that would work for me. I had ended up hospitalized (again) because I was suicidal (again). But this time my pleas for long-term care, not another intensive 4-month program were heard. A wonderful woman went beyond the call of duty to find for me a creature virtually unheard of: a psychiatrist who does more than medication management.
    She described her as “gentle.” At the time, I thought that the terms ‘psychiatrist’ and ‘gentle’ were mutually contradictory. I was scared. After all, I had tried so many things and so many of them had blown up in my face. But it wasn’t as if I had many other options left. So I decided to give this gentle psychiatrist a try.
    A year and a half later, I owe Jill my life and my sanity. There are days now when I actually believe that I might be able to build a life worth living. These days are even starting to be more common than not.
    But I still don’t know WHY it works. I want to understand what it is that is happening in that room that helps so much.
    Don’t give up hope. No matter how many things you have tried, there is a therapist out there who is right for you… and he can be found.

  • barb quester

    dear therese, i so love your honesty and openness in your posts each day. i really look forward to what you have to say.
    i can’t say enough good things about my therapist. she has picked me up and dusted me off more times than i can count in the years she has taken care of me. i may not be here if it were not for her, and the meds. maybe it is inexplicable why we need both, but i thank God for both. they both keep me sane, calm, and alive. that’s why we need both.

  • Bill White

    Dr. Jamison is simply a wonderful woman. Her story speaks volumes about her drive and mission, as well as UCLAs incredible support when she was on staff during her illness. What an employer! Thanks, Therese…

  • Meg Y

    I am in the place where I do believe in therapy with meds…but over a year (currently, not including past depressions/episodes) in trying to figure out what’s going on with my sleep (sleep study said 0% deep sleep-not good), moods (all over the place-crying, irritable, foggy thinking (i don’t think normal pple really know what that means-like you are losing your actual mind!) mad, sad, hate happy people, etc), in addition to having hypothyroidism and a 2.5 year old who kicks my butt everyday, i don’t know what to do, where to go, or how to make it better. i am at my witts end. I am tired of being in quick sand whith no way out. i hear ppl saying to just keep trying, but please, there must be a better way!! there has GOT to be a doctor out there who knows what he or she is doing, dare i ask takes insurance, and has the experience and insight to throw me a bone!! how do you find them before you miss out living your life???

  • GEM

    Hi Meg,
    Start with your insurance company. Get a list of providers that you could see. Then call a few and give a little bit of your story, enough that the person on the phone might be able to match you to the right person in the practice. Ask your friends, especially like-minded (church, for example) ones who they might recommend. You can ask for a male or female, special areas of interest, etc. Maybe there is even a website for the practice, including pictures of therapists.
    You may have medical issues, too, and perhaps your MD could recommend a therapist.
    I hope you will take the time for yourself, the time that is necessary to be the best mom you can be to that 2.5 year old! You are worth the investment.

  • Audra Bailey

    Great post. So many people I have spoken to say that what works best for them is a combination of therapy and pills. A Canadian study found positive results with Omega 3 fatty acids, however I’m not sure that this would work for everyone. Has anyone tried Omega 3?

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  • Meg Y

    To GEM:
    Thanks for your suggestions. Looking back at my post I realize I didn’t really mention my main problem seems to be the TIME it seems to be taking to “find the right combination” of medications. I know this is just part of the process…you can’t just look into your brain and see which chemicals are lacking or too high. My frustration is with psychiatric professionals who I’ve been with over the years and years who just have never nailed it down for me. I do like my current psychiatrist who is very methodical in trying to determine what exactly is going on by only changing one variable at a time. It’s just so hard to try to maintain your life at the same time with any sort of patience or peace, at least for me. I just want my brain to work right, while going to therapy, and not feel I’ve wasted the past year with no progress. I know now that even though I’m going through this terrible time, God is with me and I need to trust Him more to guide me on the right path. You also mentioned that you hope I take the time I need to get better and be the best mom I can be…I feel sometimes like I have been taking TOO much time, filling my schedule with all these Dr. appts, trying to exercise and do things to improve my condition, and it has taken a toll on my marriage. Now we are adding marriage therapy to the list of Dr. appts, but it will be worth it.
    Thanks again,

  • Humphrey

    I really wonder what the truth is. For years and years I considered the possibility that i was suffering from depression, but maybe it was just a bad marriage, professional disappointments, procrastination, various mild health problems, overly critical of myself and subdry other malaises. I did several depression screenings and all came out negative.
    Resuming therapy to help myself cope with a difficult boss and unsympathetic spouse, the bright and humble psychotherapist asked me: “Do you think you might be suffering from depression?” I said that I that it was quite possible, and quite likely that antidepressants were really what was needed. She arranged an appointment with a kind and wise psychiatrist, and a few weeks later at my own request I was trying a very low dose of prozac and the world has become a better place for me. I kept it a secret from the beast-wife, but a few weeks later she asked me what magic my new therapist was performing because she sees taht I am happier and in better mood than in many years. The next night she asked straight out: “Are you taking some medication?”
    The transformation of my life has been fabulous, and I have never looked back! Thank you wise therapist and kind psychiatrist, you have turned my life around, I wish I had done this years earlier. If not for religious faith I might not have lived to see this day, I think it was only belief (or maybe love of my children) that stopped me from ending my own life.

  • http://AddaURLtothiscomment brittany

    What page is this on?

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