> the other question is don't they know how to do anything besides
> write prescriptions? Whatever happened to psychotherapy? there are
> numerous studies showing that psychotherapy is every bit as effective > as antidepressants -
Not only psychotherapy, but also self-help groups like peer counseling
and LLL. My mother raised 8 children, returned to school and went
straight through for a PhD in Psychology from Brunnel University,
London, England at the age of 56. Her thesis and dissertation topics
evolved from her hypothesis that self-help groups (exactly like LLL) are
*as effective for alleviating depression as traditional psychotherapy*
(not really very wise research for a psychologist, as she was proving
the need for her services didn't exist!) Anyway, the first group she
studied were American "home-bound women" (ie - stay-at-home moms)
(because this was what she knew best). She thought depression had
increased in her lifetime as women in the neighborhoods left home for
work, and, at the same time, there was the demise of culturally
sanctioned neighborhood based women-support groups (quilting bees,
garden clubs, canning circles, etc) and the loss of the close-by
extended family. Later, she repeated this study on British housewives,
then paraplegics, then on Saudi Arabian housewives, and finally on Saudi
men. (She also validated the Beck depression inventory for the Saudi
culture.) The end result? No matter which type of depressed people she
studied, her hypothesis was confirmed.
Her research showed that self-help groups *are* as effective in
alleviating depression as traditional psychotherapy. Go LLL! (P.S. The
least depressed group she studied? Saudi women! The most depressed group
she studied? Saudi men! She thinks because they had enormous pressure to
provide for and keep peace between as many as 15 wives and as many as 52
children - ??)
When I mentioned to her this LactNet thread of postpartum depression
(PPD) and BFing and the medication approach, she said the following,
which although not exactly BFing, is pertinent to what we do and may
give us with insight to help our moms who find themselves depressed:
PLease keep in mind this will not apply to every PPD woman. As already
pointed out in the discussion so far, there are some other causes for
depression (biochemical imbalance, etc). However, if those other causes
have been ruled out and a PPD still remains, then this line of thought
may be helpful.
Paraphrasing Julia West, PhD:
"PPD, IMO, isn't really depression, but grieving - grieving over the
losses that your body will never be the same (body image), that your
life will never be the same (lifestyle), that your roles (as wife, as
responsible for dependent little people) have changed (identity), and in
fact, the whole process hurt and now "makes me feel awful." Yet the new
mother is not permitted to disclose these thoughts because society says,
with each baby, "How wonderful! How fortunate you are! What a blessing!"
Society doesn't permit this grief work. To counter these (strong)
opinions would make the mom feel somehow ungrateful or odd, so the
feelings are repressed. Yet society *does* expect the mom to be tired,
exhausted and weepy (symptoms of depression)(not necessarily normal but
has become "normal") - this is allowed. Women may substitute these
culturally sanctioned expectations and depression for her (now)
repressed feelings, and she gets stuck there. Actually, some women may
be weepy due to these (repressed) losses and not just to the hormonal
changes. In time, without any opportunity to express them, "weepy"
becomes a way of life and - a dignosis of depression is made. When the
depression doesn't show up until the 3rd or 4th baby, the woman is
"revisiting" her original grief which was never resolved. If she goes to
her MD or ends up with a psychiatrist, their training emphasizes
medication (if all you have is a hammer, then everything looks like a
nail). Psychiatry is male-dominated and has known biases against the
female experience. (This is not a put-down; just a statement of fact.)
One patient with one child came to me with a 15 *year* diagnosis of PPD
- had been on all and was still taking meds, gone through traditional
therapy - nothing helped, until we explored the grief issues."
BTW, there are other therapists in the pyschological community who are
trained in "talk" therapy and whose licenses do not permit prescribing
medications; go to them and not a psychiatrist-MD if "talk" - not drugs
- is what you want and/or expect. Choose your practitioner well.
I think my mother is onto something. These kinds of issues and
discussions find a safe haven within LLL. As 1-to-1 LCs, we can even
broach some of these topics. Many times, caught early enough and
verbalized, the issues dissolve rapidly. Unexpressed, they fester below
the surface, sapping a mom of her energy and well-being (like trying to
keep a beachball submerged under water.) FYI, my mother is in private
practice in Phoenix, AZ. Her pertinant citations are:
Self-Help Groups and Depression
International Journal for Advancement of Counseling. 1981: (4) 161-164.
An Arabic Validation of a Depression Inventory
International Journal of Social Psychiatry. 1985: 31(4) 282-287.
Spinal-Cord Injury: The nature of its implications and ways of coping.
International Journal of Rehabilitation Research. 1983: 6(3) 364-365.
Katharine West, BSN, MPH
Sherman Oaks, CA
|
