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Monday, January 22. 2007

Final, final A Psa A Meeting thoughts

I thought that I had completed my thoughts about the Psychoanalytic meetings, but I have one more thought to briefly put on paper.

In the US, psychoanalysis is mainly a research tool. It is not, and never will be, a widespread treatment for disorders of the soul because most people cannot use it, and because people have become so dependent on their insurance which will never pay for analytic treatments. Thus it will remain an endeavor for the few, available to the few, and practiced by an elite few (mainly in a handful of metropolitan areas) - the high priests of the craft of psychological treatment.

(Incredibly, in Europe government insurances pay for psychoanalysis, but many believe that if paying for it does not hurt, it will not work. Nobody appropriately values "freebies".)

So, in the US, analysis is a benefit for the few - truly an elective procedure -  but a source of data and information and theorizing which can benefit many. We have yet to find a better method than Freud's for investigating the depths of the heart and soul.

Posted by Dr. Joy Bliss in Psychology, and Dr. Bliss at 22:04 | Comments (9) | Trackbacks (0)

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It's interesting but sad that it is so rationed. I know, life's not fair. Perhaps a lottery system? Or triage, and lucky people who meet the protocols get it free? Or audition for it? It is bizarre that with the care of the psyche, just as with cutting edge physical care, treatment decisions are so driven by insurance instead of medical necessity (and I don't mean m.n. as defined by an insurance clerk or retired hack MDs professionally denying insurance appeals...
#1 retriever on 2007-01-23 06:16 (Reply)
It's not rationed. It's elective. You can make a strong case that it should not be covered by insurance.

Not many people can do it, and they are only around big cities.
#2 Dr. Bliss on 2007-01-23 07:57 (Reply)
Point taken. Nobody has a right to it or will die without it. Like all arts, succoured by rich patrons when not starving in a garret, and the Romanovs and robber barons and Renaissance princes are now remembered fondly for their patronage...but it still seems kinda sad to me. As for me, it's analysis (if I only had a fit diagnosis)or kids' college. The latter matters more than the psyche of a tormented middle aged Cliffie. We screwed up intellectuals resort to self analysis and envy richer friends who can do more..
.
#3 retriever on 2007-01-23 08:31 (Reply)
Dr. Bliss,

Psychoanalysis generally takes a long time. Is that part of the reason family structural cognitive therapy is more readily available? That is - so people can get 'fixed' faster and perhaps with less trauma? (Although, frankly, getting 'fixed', no matter the therapy involves certain innate trauma.)

Insurance companies do run the mental health system. Six days in the hospital and out you go with your little bag of antidepressants, benzodiazepines, anti-psychotics, and Award for Having Hope. (The ones who are really hoping are the insurance companies, and they're hoping you'll keep taking the numbing pills.)
#4 Phoenix on 2007-01-23 12:54 (Reply)
You said it, P. But the shrinks dn't get it unless they or a loved one have had to fight for care. I emember battling one company after my psychotic and suicidal
8 year old's barely English speaking psychiatrist told me weeping that the insurance
Company had asked had the patient tried to kill himself in the MDs sight in the previous 24 hrs. No? Out to the community. Husband lost job becuse of needing to keep sick kid alive at home while I struggled to hold onto the health insurance providing job. If you're not outraged, you're not paying attention,
#5 retriever on 2007-01-23 13:21 (Reply)
jeez, retriever--you're due some better luck--hang in there, it's bound to come.
#6 buddy larsen on 2007-01-23 16:56 (Reply)
It did get better eventually, thanks to good doctors, loving church family, power of prayer, and (gasp)some temporary help from the state...Not all governmental programs are boondoggles and pork...
#7 retriever on 2007-01-23 17:12 (Reply)
That is sad, Retriever. Double trauma for you - worrying about your little one and having to fight to level the worry.

I am glad to hear things are better. There is nothing scarier than a young child exhibiting symptoms as you mentioned. My brother went through the same with his son.

Yes. Good for you for getting help from wherever. You are right - they are there.
#8 Phoenix on 2007-01-24 00:58 (Reply)
Phoenix,

Length and cost of treatment surely exert major effects on the preference for cognitive and family treatments among insurers and many patients. In the case of the cognitive therapists and, to some extent, systems therapists, an increasingly outspoken defensive antipathy toward the notion of dynamic unconscious processes greatly affects many psychotherapists.

Frankly, I've seen greater recognition of unconscious activity among students of literature and even among a few friends in the professional acting community than I see among fellow clinical psychologists. The situation is no better in psychiatry, clinical social work and, heaven help the sick, among counseling psychologists who defensively ridicule the notion of psychopathology and proceed to treat patients who are suffering with serious, even dangerous, psychological difficulties.

I also agree with Dr. Bliss that a good case can be made for denying insurance coverage for psychoanalysis. Aside from economic arguments for that case, I would assume that Dr. Bliss is also referring to some good clinically-based reasons.
#9 Dr X (Link) on 2007-01-24 11:56 (Reply)

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