Tuesday, November 29, 2016

So what would I do if I had PTSD?

Image result for psychoanalyst
A Dangerous Method (2011)

  1. Not drink any alcohol for the duration.
  2. Start a rather intense physical exercise regimen.
  3. Not take any benzodiazepines (e.g., Xanax, Ativan).
  4. Eat more healthy than I ever have (probably full paleo).
  5. Not take any sleep medications (e.g., Ambien, Lunesta).
  6. Ask everyone I know for the name of a really, really good psychotherapist. Not a marriage counselor. Not a "life coach." Not a substance abuse counselor. Someone who treats people with serious mental health problems, every day. Someone whose caseload usually includes suicidal patients. Someone who calls them "patients" and not "clients." Probably, somebody I address as "Doctor." Probably, somebody who dresses for work better than I do. Most definitely, somebody who reads Dostoevsky, Tolstoy, Shakespeare, and Homer. Somebody who has read plenty of Freud, and Jung, and Frankl. Someone much more likely to interpret a dream than to assign me homework in which I identify my "cognitive distortions."
  7. After a few sessions, if I don't like this therapist or don't feel that he or she understands me or is not putting my best interests ahead of their own, then I would find someone else.
  8. Once I find the right psychotherapist (with the right office -- I'm partial to Oriental rugs and leather armchairs), I'd settle in for twice-weekly sessions for the next six months.
  9. If I didn't see any improvement after two months of twice-weekly psychotherapy, I would consider antidepressants. If I was still having trauma-related nightmares more than twice a week, I would consider prazosin. But I would probably end up not taking any psychiatric medications.
  10. Throughout the therapy, I would be trying a multitude of live-enhancing activities, e.g., hiking, oil painting, learning a new language, bricklaying, meeting new people, etc.

That's what I would do. I suspect that many other mental health professionals would do something similar. What I wouldn't do is go knocking at the door of a VA hospital, begging to be let into one of their Cognitive Processing Therapy groups.

By the way, those 48 sessions of individual psychotherapy, at $150 per, cost $7,200 (if I don't have insurance). It seems like a lot, until you consider the economic impact of having PTSD (i.e., how it reduces your earning capacity).

So, ladies and gentlemen, why don't we give each of our combat-PTSD veterans a voucher worth $7,200 for psychotherapy from a quality independent practitioner of their choice? Such an initiative would cost a lot less than giving them lifelong disability pensions of over $2,000 a month.

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