psychiatry

Tue Sep 11 12:50:25 CDT 2007

Makes me want to open a private training center,
our own version of Beacon.  Not a hospital, but a
center that brings all of us together to teach the many
applications for our method.   Maybe that's what conferences
are for, but wouldn't it be AMAZING if Boughton Place could
be turned into a Psychodrama University (of sorts) with a sister-brother
branch at the Moreno Museum outside of Vienna!

Anyone want to work on such a project with me?

Ed

On Sep 11, 2007, at 1:38 PM, HV Psychodrama wrote:

> The psychiatrist who owns Four Winds told me, last week, that  
> psychodrama
> was basically the only psychotherapy that is having real impact at the
> hospital these days. But I also know that Four Winds is one of the few
> hospitals around that actually have psychodrama, and we are somewhat
> protected by the fact that the owner, Sam Klagsbrun, believes so  
> strongly in
> it.
>   We also have some fine MDs, including one who is certified in  
> acupuncture
> and Chinese herbs, and truly believes that a lot of the increase in
> adolescent problems of environmental, but the insurance companies  
> run the
> show, these days, telling the docs what to do. Heavy heavy sigh....
> ----- Original Message -----
> From: "georgia rigg" <georgiaarigg at yahoo.com>
> To: "Adam Blatner" <adam at blatner.com>; <list at grouptalkweb.org>
> Cc: "Ann Hale" <annehale at swva.net>; "HV Psychodrama"  
> <hvpi at hvc.rr.com>;
> "georgia rigg" <georgiaarigg at yahoo.com>; "Karen Carnabucci"
> <karen at companionsinhealing.com>
> Sent: Tuesday, September 11, 2007 12:56 PM
> Subject: Re: psychiatry
>
>
>> I would like to say, Adam, that my tenure in the psych
>> hospital, was in the dark ages of the 70's & 80's.
>> Not so--I worked there for six years, starting in
>> l999, so what I am reporting is within the last 7
>> years.  Heavy sigh!  Georgia
>> --- Adam Blatner <adam at blatner.com> wrote:
>>
>>> Reflections on Trends in Psychiatry
>>>
>>>     The field of psychiatry is a very mixed bag,
>>> with a fair number of colleagues whose
>>> approach I am proud of, and, alas, many to whom I
>>> would not refer patients.
>>>
>>> 1.   About psychiatrists presenting at the APA
>>> conference:
>>>              For a while, Dean Elefthery hosted
>>> symposia--- I was a co-faculty at the 1976
>>> one, as well as Lew Yablonsky and some others; then
>>> Neville Murray did it around 1980---
>>> including folks like Adaline Starr, etc., and me.
>>> Other conferences I missed around that
>>> time. But in 1985, after Neville died, I took over
>>> this workshop and presented psychodrama
>>> to an average of 25 professionals, 2/3
>>> psychiatrists, at a paid course at the annual
>>> American Psychiatric Association conference. It was
>>> received well enough so that I was
>>> invited back and we gave this class each year for
>>> about 9 years. Then it shifted more
>>> towards biology and the courses stopped. Some of
>>> these 1985-1994 classes were co-taught by
>>> folks such as David Swink, Eva Leveton, etc.
>>>       I stopped being active in the APA around 2001
>>> and began to move into
>>> semi-retirement.
>>>
>>> AH: Maybe Amy Konkle, MD in Indianapolis could get
>>> it going again. I believe she is a CP.
>>> It would help to bring the new docs up to date.
>>>      AB  responding also to changes not only in
>>> psychiatry, but also in the financing of
>>> care. The idea of longer-term in-patient care was
>>> more prevalent through the early 1990s.
>>> Indeed, there was an expansion of such services in
>>> the 1980s, which ended up backfiring!
>>> There were regulatory issues mixed with
>>> entrepreneurial capitalism. By the mid-1990s, the
>>> trend was accelerating towards very short-term
>>> hospitalization and follow up with day
>>> treatment, group work, etc., but there wasn't as
>>> much funding so this follow-up wasn't
>>> always, well, followed up.
>>>
>>>     Responding to requests for certain medical
>>> tests---the problem is that there is little
>>> evidence that such tests are meaningful, leading to
>>> doing anything different for the
>>> patients. The claims for orthomolecular psychiatry
>>> are, along with literally other
>>> alternative medicine health care claims,
>>> un-substantiated. The research just doesn't
>>> support that this approach does much more than
>>> homeopathy. (I know, some folks believe in
>>> that, too!)
>>>       So, while there are indeed problems with the
>>> influence of the pharmacology industry
>>> and other semi-corrupt practices, this does not mean
>>> that the entire enterprise is
>>> meaningless. There will need to be a continuous
>>> process of finding the proper balance.
>>>         Many psychiatrists are quick to admit the
>>> limits of knowledge. The problem is that
>>> when people are desperate and in great psychic pain,
>>> are incredibly self-destructive,
>>> families and social networks and the patients
>>> themselves--- it depends--- often seek help
>>> even when the experts don't have perfect tools for
>>> diagnosis and treatment---because they
>>> aren't known yet!
>>> As for the status of psychodrama---well, it is
>>> important that we not feel too entitled.
>>> Many other therapies also have blossomed and faded,
>>> lacking sufficient empirical evidence
>>> to justify their use. Some were very time-intensive,
>>> costly, and many were under-developed
>>> regarding any research that determined the proper
>>> indications and contra-indications.
>>>        Even psychodrama was problematic through the
>>> 1970s, with many then (and still
>>> today, alas) doing the process with little training.
>>> Nor was the field fully mature then,
>>> nor is it today. There are still new frontiers.
>>>       A number of modifications of technique have
>>> been introduced by Kate Hudgins and
>>> others regarding working with people who are trying
>>> to heal their traumas. Many still
>>> don't know or use these approaches.
>>>          So the field continues to evolve.
>>>
>>>    More, since the 1970s some of the more recent
>>> developments have arisen to compete with
>>> psychodrama (and other more popular approaches), so
>>> what's more in now is, for example,
>>> the Dialectical Behavior Therapy of Marsha Linehan
>>> (which is skill building and has a few
>>> areas in common with role training); and of course,
>>> the better research-documented
>>> Cognitive Behavior Therapy. More, many therapists
>>> are integrating elements from many
>>> sources.
>>>
>>>    So, Georgia, when was it that you worked in a
>>> psych hospital where the "old doctors"
>>> admired psychodrama, my use of John Mosher's Healing
>>> Circle, and my attempts to help the
>>> clients create therapeutic communities?
>>> When did the new, just out of residency "baby docs"
>>> come on board? You said, "In a short
>>> time, I was threated with firing if I didn't stop
>>> psychodrama, and forget therapeutic
>>> communities." It could be that the key power wasn't
>>> the baby docs but the flip that
>>> happened in the 80s as business managers came to
>>> really determine what would be done, and
>>> medical directors became puppet figureheads rather
>>> than leaders. These collaborated with
>>> the trend towards evidence based medicine in way not
>>> that dissimilar to the trend towards
>>> testing in another institution---public schools. The
>>> underlying theme was
>>> "accountability," and many approaches and
>>> professionals couldn't make the cut.
>>>
>>> well, that's enough for now. Warmly, Adam Blatner
>>>
>>>
>>
>>
>>
>>
>> _____________________________________________________________________ 
>> _______________
>> Shape Yahoo! in your own image.  Join our Network Research Panel  
>> today!
>> http://surveylink.yahoo.com/gmrs/yahoo_panel_invite.asp?a=7
>>
>>
>
>
>
> Grouptalk mailing list
> List at grouptalkweb.org
> http://grouptalkweb.org/mailman/listinfo/list_grouptalkweb.org