The case for minimizing or eliminating medication in therapy
This week I wanted to talk about medications, and the possible role, if any, that they might play in your approach to therapy. As a professional counselor with years of experience, I feel strongly that therapy is best approached without medication. In my view, medications only serve to obscure the roots of my clients’ problems, making it harder for me to understand where the solutions lie.
As I see it, there are three main option when it comes to how you approach therapy, and while I strongly advocate for a medication-free approach, as you will see, it’s not always that simple.
Disclaimer: I am not a doctor! These are purely my own opinions gleaned from years of personal observation and experience.
Option 1: The medication-only approach:
It would seem they have a pill for everything these days. Pills for balancing your brain chemicals, pills to make you work harder, pills to kill your anxiety, pills to make you sleep, and even pills to make you feel nothing at all. These are not included in my field of expertise and doctors know best when and why any of these medications might be appropriate.
That said, the medication-only approach could be useful if you are going through a temporarily difficult time, such as a divorce, and you want a quick fix to get you through the pain, rather than taking a closer look at your issues. Maybe you just want to get through your exams. Or end your insomnia without exploring the route cause. Pills can be a short-term solution, and in some cases, that might be just exactly what you needed.
But medications come with at least several negatives to consider. For starters, they’re not always as quick a fix as you think: You might have to try several different drugs before you find the one that feels right, which will involve repeat visits to the psychiatrist—and even when you do find something that “works”, you may experience unpleasant side effects, which could outweigh the benefits.
Then there’s the issue of building dependency and tolerance over time: You start with a dosage that works at first, but over time the benefits wear off—the anxiety, sadness, whatever it may be, creeps back in, and you find yourself upping the medications dosage just to feel normal again. This can result in a long-term dependency that can be extremely hard to quit if you ever wish to do so in the future.
Option 2: Combining medication and therapy
Often, clients come to me seeking to combine medication with therapy. In my opinion, this approach can make sense when there is a true chemical imbalance occurring in the brain. I’m talking about extreme cases here: if the client is having a true bi-polar episode and needs to find some kind of balance immediately, or if the person is experiencing schizophrenic symptoms such as visual or auditory hallucinations.
But barring emergency situations such as those mentioned above, I want to stress that in my personal approach to therapy, I find that if the client is medicated, it is harder for me to access the underlying emotions and root causes of his or her problems. The medications act like a mask that can be hard to penetrate, and the underlying issues that drive the sadness, anxiety, depression, or whatever it may be, remain hidden and inaccessible.
Option 3: The therapy-only approach
This is what I do as a professional, and what I advocate for, if at all possible. It isn’t always easy: therapy requires that the client commit to putting in real work. The client must also be open and honest, which isn’t always easy. But in my years of experience, I have found that the most positive and lasting progress I’ve seen has been with clients who stayed away from or kicked the medications, and did the honest work of getting to the bottom of their problems.