I have had doubts about the current medication oriented approach to psychiatry for some time. After studying for a high school psychology class with some peers, I became convinced that I wanted to become a psychiatrist. My early exposure to alternative and holistic medicine clearly had an influence on my thinking, but in no way altered my core passion for the power of the human mind.
Andrew Weil became a friend and mentor after he served as an advisor on my honor’s thesis about theories of consciousness in the early 1970s at the University of Arizona. So, I was the rare bird that entered medical school with some of my own ideas about what healing was and about the value of safe tools to unleash the innate healing power that lies within all of us. Needless to say I felt beaten down, discouraged and depressed after I really experienced what occurred in hospitals and medical school.
When I finally got to my psychiatric training at a Columbia program in New York I had worked for four years as a primary care doc in rural Arizona and was ready to learn my chosen craft. I can remember well one of my first patients that I treated with the support of faculty supervision. He was a forty-year old insurance salesman from rural upstate New York. He had been experiencing some depression and alienation from his wife. Bill (pseudonym) had two lovely young daughters and he was very involved in their lives. He lived about an hour away and on-going psychotherapy was not practical. Prozac had just been released and was all the rage in psychiatry. After discussion with my supervisor we decided to treat him with the new silver bullet. I wrote the prescription for 20 mg, one per day by mouth in latin script with a high level of ritual (for me at least). After wrapping up the visit I asked him to return in 3 weeks for a recheck.
His wife phoned me at about the two-week mark to inform me that Bill had jumped from a local bridge into an icy stream killing himself instantly. She said that he had been complaining of an escalating intensity inside his head that would not stop. He had keep grabbing at his head and crying, “Make it stop, make it stop.” Bill did not follow her advice to call me and ask me if that was supposed to happen and ask about other options. She was a lovely woman and told me that she did not blame me and thought that the medication itself was to blame. She retained an attorney and sought relief from Eli Lily, joining a group of similar patients seeking a class action against the manufacturer.
As you might imagine, this overwhelmed me as a young resident. I was devastated by the loss of my patient, sad for his family and confused by what this meant about my training, practice and professional tools. I was desperate to learn, but ambivalent about a central facet of my professional toolbox. I have remained ambivalent to this day almost thirty years later. I clearly see that medications can help some folks ease their burden and support a process of recovery. Sadly, far too often medications create problems and even limit recovery. Perhaps the greatest drawback of psychiatric medications is that we lose sight that we have to do more: more assessment, more treatment, more education, more encouragement. Medication currently forms the central and pivotal focus of psychiatric hospitalization in this country. This needs to change.
After working as medical director of a psychiatric hospital, addiction program and four different residential treatment centers I have a clear vision of what folks need to truly address their mental health issues and step onto the path to healing. Medication does not form the core of my vision. People, like all that lives, function as a complex system. We must understand the imbalances in each ecosystem, each individual, if we are to foster the true recovery of well-being. We must support balance on every level. We must sort out the roots of imbalance and correct them, but most of all we must offer the suffering individual the awareness and tools critical for self-care and direction. It was with these goals in mind that I founded Wholeness Center as a multi-disciplinary clinic to apply this philosophy.
The team at Wholeness Center has been pioneering integrative mental health for the last four years. We treat individuals from all over the country who come to Fort Collins to experience a very different approach to mental health treatment. In response to growing demand, we have decided to roll out an innovative new program that will offer people with serious or chronic mental health issues a true alternative to conventional psychiatric care.
Our new Integrative Psychiatric Intensive Program delivers a 5-day immersion in the best of integrative, holistic and natural medicine. We make a thorough evaluation of metabolic, genetic, neurological, dietary and lifestyle factors. This thorough assessment combines with an empowering skill based education that helps someone move beyond crisis and towards true stable well-being. We craft a comprehensive treatment plan for each individual to take home and recover.
This program provides a very real alternative to hospitalization for adults (over 18 years old) with no current safety issues. Psychiatric hospitalization is clearly the treatment of choice when a person presents with safety issues such as active suicidal ideation or a very disorganized psychosis. Most often psychiatric hospitalization amounts to an aggressive trial of multiple psychiatric medications without any assessment of underlying factors. Very little is done to empower the individual with new skills/interventions to manage stress, diet, sleep, metabolic, genetic or related concerns.
Psychiatric medications can offer some very short-term benefits, mostly in terms of sedation. It is clear that these medications cure no psychiatric illness; they only superficially manage symptoms. As Whitaker has pointed out, the research demonstrates that the benefits do not sustain. Additionally, in our experience they can often hold people back from true recovery of health and well-being. At times medications can function at as catalysts of change, but do not offer a consistent foundation for recovery. As such we hold a cautious and conservative approach.
The modern practice of psychiatry is not very satisfying for the practitioner or the patient. Our psychiatrists have decades of experience in hospitals and treatment centers. This experience taught us that outside of immediate safety issues hospital care delivers little lasting benefit. The patient is often left with less autonomy and empowerment. Psychiatry is the only medical specialty that ignores their target organ (the brain) and underlying physiology. This has to change.
* * * * *
We hope that our new model begins to shift the options and the care that people in crisis are offered. Psychiatric care must move forward and Wholeness Center wants to lead the way. This new program represents a leading edge of mental health care in the US. It provides individuals with a thoughtful and empowering alternative to hospitalization and the excessive reliance on medication.
For More information:
Leo Salazar at 970.221.1106
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.