August 19, 2011

What if No One Made Antidepressants?

By Dr. Peter Breggin

Drug companies stop making antidepressants? The possibility is not so farfetched.

A headline in Britain’s Guardian puts it this way: “Research into brain disorders under threat as drug firms pull out.” The subhead explains, “Scientists warn of big financial and social impact while fear of litigation and expenses is linked to move.” Apparently, two British-based companies, GlaxoSmithKline and Astra Zeneca have announced that they no longer intend to research, develop or market any new antidepressants.

The Guardian article quotes neuroscientist David Nutt, who warns that if this “brain research” is stopped it will have dire consequences in regard to treatment in the field of “brain disorders.” As admitted in the Guardian report, Nutt has such close ties to GlaxoSmithKline that he was disqualified from participating in a 2003 British government inquiry into antidepressant hazards. Nutt takes the position, “All drugs have side-effects. The risk-benefit analysis of antidepressants is overwhelmingly positive.”

What’s really going on here? Because of the growing scientific evidence for antidepressant adverse effects, the cost of litigation — even while settling almost every case — has grown overwhelming. I am proud to say that I have contributed to these costs through my books, scientific articles and my participation as a scientific expert in many product liability cases against drug companies in regard to suicide, murder and fatal drug reactions associated with the antidepressants. At the same time, meta-analyses have called into question the efficacy of these drugs.

I also want to contribute to the solution, which lies in human services and not in drugs. For decades, I have puzzled over how to make a psychotherapy training film. I did not feel it was ethical to film my own patients, even if they agreed to it. It’s up to the therapist not to involve patients in the therapist’s projects, however useful they may be.

Then, a new opportunity began to dawn on me last year when I was preparing to teach my annual course on empathic therapy and counseling in the SUNY Oswego Department of Counseling. At the last minute I realized the futility of teaching therapy from books or outdated films, mostly based on filming patients, which I find ethically unacceptable.

What else could I do? I changed the curriculum for the 5-day course and turned it into a role-playing seminar. The experience was so successful for me and for the students that I decided I could do a realistic training film without filming my own patients. But much as I would not ask my patients to be filmed for my own project, I didn’t want to ask my students, either. So I set up a no-fee private invitation-only seminar on psychotherapy. The attendees would get a free psychotherapy seminar in exchange for agreeing to be filmed and possibly to role play with me.

The seminar was so intense that there was time for only three role playing examples. A man who is making a film about his life decided to be himself, in effect becoming a “patient” for the film. In the session, we worked on empowering him after a devastating manic episode and hospitalization followed by years on lithium. It was hard but rewarding work. A college student friend of mine decided to play herself a year earlier in her life, when she was in an abusive relationship. It was deeply moving. A counselor role-played a profoundly depressed woman with hallucinations and delusions who wants to kill herself and her ex-husband. It was chilling, and therapy gains were hard won with this difficult “patient.”

Perhaps unique in therapy training films, several therapists in the audience critiqued my work and made suggestions for different approaches, which I then tried on film. The film begins with my introduction — “What is Empathic Therapy?” — and concludes with a more formal critique of my efforts by two very experienced therapists.

Instead of new antidepressants, what the world needs are new and better psychotherapies, and more available and better-trained psychotherapists. I hope an increasing number of therapists will be inspired by my film to find ways to share their approaches with us on film.

You can find my new training film on my website. It’s called “Empathic Therapy: A Psychotherapy Training Film.”

The goal of the film is not to present a new therapeutic approach. The goal is to help bring out your best as a therapist, and also as a client, a patient or as someone who wants to live a more empathic life.

Originally published on The Huffington Post