Generally speaking, psychotherapy and medications used together are more effective than either alone. Also, generally speaking, medications normally work faster, but the benefits of therapy usually last longer. It is my style as a psychodynamic psychotherapist to manage my patients’ medications myself. In patients with extremely complex disorders, they may have a psycho pharmacologist they see concurrently while working with me in therapy. In some cases, I may consult with a senior psychopharmacologist about medication strategies.
Medications can be extremely helpful for many psychiatric conditions such as depression, anxiety, bipolar disorder, ADHD, and psychotic disorders. However, any medication does have side effects, and because of this it is important to take medication only when it is indicated. In my practice, medication is for those patients who are significantly impaired by their mental illness, and psychotherapy is not doing enough to improve their performance at work, or their relationships with friends and family. Before I start medication, I will perform a detailed diagnostic evaluation that may include a physical exam, laboratory tests, other medical tests, and consultation with other medical specialists. After starting medication, I take special care to keep patients informed about their medications as well as closely monitor them for any side effects.
It is difficult to say how long patients have to stay on their medication. Each person is unique and therefore may respond differently. In my experience, if a patient is doing well for a full 8-12 months into treatment, we can think about the possibility of tapering off medications. However, there are some conditions such as bipolar disorder or recurrent depression where someone would benefit from taking medication for a longer period of time.
If medication is needed, that will be discussed in detail at the time that it presents itself, both from the point of view of your own anxieties and attitudes and prior experiences, as well as my being clear about my rationale, the evidence that exists for the use of medicine in your situation, what to expect from treatment, etc. I am a physician who believes that physicians don’t give adequate attention to patient education, but do my best to have open dialogue and to facilitate the sharing ideas of concerns and information. I would say that at least 20% of my patients have some form of ADHD. Most do not present complaining of this, but knowledge of its presentations in adulthood, can lead to the suggestion of a work up: an intense family history, a well-documented clinical review instrument that can give us a statistically probability that you have ADHD. Depending on the subtype, psychopharmacology and types of CBT can be used in addition to psychotherapy. And of course, there are many other types of psychiatric problems and simple human emotional and relationship issues that come up in practice and may affect you, and we will learn together about your particular issues.
"In the last 30 years, I have turned to Dr. Benson during times of tragedy and upheaval for her wisdom, intelligence, insight, humor and empathetic involvement.Dr Benson doesn't listen to your joys and anguish, she feels them with you. Her imprint of deep empathy has remained with me as a kind of silent witness in my life.”Testimonial volunteered by a patient of five years.