Talking Therapy Episode 8: Why Psychotherapy Fails: Misdiagnosis

Hosts:

Producer:

Alan Kian, MA, York University
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Marvin Goldfried is a distinguished professor of psychology at Stony Brook University, where he helped to develop the graduate program in clinical psychology—he is the cofounder of the Society for the Exploration of Psychotherapy Integration. Allen Frances is a professor of psychiatry and chair emeritus at Duke, and was chair of the DSM-IV task force.

Marvin describes the evolution of his psychotherapy orientation as psychodynamic, behavioral, CBT, and eventually integrative. He practices, teaches, and supervises what works clinically using direct and indirect evidence base.

Allen describes his approach to psychotherapy as “whatever works” or “no one size fits all”. He was trained and taught at the Columbia University Psychoanalytic Center, but remains equally interested in brief, supportive, cognitive, behavioral, interpersonal, and family therapies.

Please enjoy this week’s episode!

[FortheLoveofGamingYT]

Thanks for the interesting information. As someone who has had mental illness, mainly a result of heavy cannabis use, when diagnosed, I noticed they didn’t want to diagnose me with weed psychosis, instead an unknown cause of illness. Now I’m sober, and my psychiatrist still acts like I’m still in psychosis, some major diagnosis. The reality is I’m not in psychosis and feel literally I had weed psychosis. But again, the doctor has no two cents about if my whole diagnosis was from thc use. They even told me to smoke weed rather than drink, when in fact quitting weed nearly solved my mental health issues. I have a long term goal to at least check for a rediagnosis, but at the moment I’m stuck with a possible mislabeling of my illness.

[KyivLavra]

Very glad to hear you mention sleep deprivation. I started about six months ago regularly inquiring, esp. during an intake, about patients' sleep.

[anitat]

I wish the average therapist would at least be willing to consider that treatment fails. Have the readiness to understand half the things you brought up.

[joelhencken]

Very glad you mentioned Covid brain fog. But what are we as therapists to do, since so far (AFAIK) there are no medical treatments for Covid brain fog (etc)?
I also find very helpful the point about 'comorbidity' not necessarily meaning multiple separate causes.

[lamentate]

The main issue is that too much emphasis is placed on 'evidence based treatment' and 'treatment modalities', which basically amounts to therapists with a grab bag of tricks and no real world knowledge or analytical skills.

Psychology needs to be combined with philosophy and the humanities again. It isn't a real science and never will be.

[iankloss]

Your comments about the complementary nature of diagnosis & formulation (and the risks of ignoring either) are hugely important & not talked about nearly enough.

[chachi-rgju]

Nice of them to admit their part in the shit storm of neoliberal mental health.

[albussnape]

There is ridiculous and harmful reliance of the insufficiently educated and the arrogant on the DSM to pronounce “diagnoses”. Interesting that Stony Brook better educated their students, at least in the past. Thank you for addressing the issues involved in this segment. Now, use the influence you and like-minded colleagues have to influence positive change in “Therapy World”.