19 Lis 2018, Pon 19:14, PID: 772131
(19 Lis 2018, Pon 18:15)Phobos napisał(a): Proszę mi niewkręcać kitu że gadką można pomóc, a jeśli ktoś w to wierzy proszę mi wykazać jak niby to działa?
Współczesna nauka nie lekceważy wpływu psychoterapii. Mówi się na przykład o wpływie terapii (jako szczególnej formy uczenia się) na ekspresję genów czy na działanie pętli neuronalnych. Pisze o tym nawet Stahl, psychofarmakolog znany z tzw. "California rocket fuel":
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Cytat:Psychotherapy as an epigenetic “drug”
Psychotherapy has traditionally competed with psychopharmacology. As drugs have become the more
dominant treatment, the pharmacological approach
has been increasingly criticized as limited in scope,
lacking in robust outcomes, and too heavily influenced by the pharmaceutical industry. However,
drugs and psychotherapy may have a common neurobiological link since both can change brain circuits. It
is not surprising, therefore, that both psychotherapy
and psychopharmacology can be clinically effective
for treating psychiatric disorders, or indeed that combining them can be therapeutically synergistic. Psychotherapy, like many other forms of learning, can
hypothetically induce epigenetic changes in brain circuits that can enhance the efficiency of information
processing in malfunctioning neurons to improve
symptoms in psychiatric disorders, just like drugs.
Psychotherapies can thus be conceptualized as epigenetic “drugs,” or at least as therapeutic agents that act
epigenetically in a manner similar or complementary to
drugs. Inefficient information processing in specific
circuits correlates with specific psychiatric symptoms.
Not only can genes and psychotropic drugs modify
various neurotransmitter systems to alter the activity
of these circuits and thus create or alleviate psychiatric
symptoms by changing the efficiency of information
processing in these circuits, but so can environmental
experiences such as stress (see Figures 6-40 through
6-43), learning, and possibly even psychotherapy. Drugs
can change gene expression in brain circuits as a downstream consequence of their immediate molecular
properties, but so can the environment, hypothetically
including psychotherapy. That is, both good and bad
experiences can drive the production of epigenetic
changes in gene expression, and indeed epigenetic
changes in gene transcription seem to underlie longterm memories, good and bad. Bad memories of
childhood trauma may trigger psychiatric disorders by
causing unfavorable changes in brain circuits; good
memories formed during psychotherapy may favorably
alter the same brain circuits targeted by drugs, and
similarly enhance the efficiency of information processing and thereby relieve symptoms (Figures 6-40
through 6-43).
Experimental animals have epigenetic mechanisms linked not only to spatial memory formation
but also to fear conditioning and reward conditioning, models for mood, anxiety, and substance-abuse
disorders. Both drugs and psychotherapy can facilitate the formation of new synapses that block memories of fear or reward and provide a potential
explanation not only of how psychotherapy can hypothetically change symptoms by altering neuronal circuits, but how combining drugs that facilitate
neurotransmission could potentially enhance the efficacy of psychotherapy in changing neuronal circuits,
and thus reduce symptoms.
If both psychotropic drugs and psychotherapy
converge upon brain circuits, maybe their combination can be harnessed for enhanced efficacy and
better outcomes for patients with psychiatric disorders. The question is how to harness the potential
of this approach and direct it most effectively to the
relief of psychiatric symptoms. What are the techniques, what is the role of the therapist, what training
is needed, how can this be standardized and made the
most efficient over time with the fastest onset of
action, how to measure the neurobiological and
symptomatic results of this approach, how to assure
that any progress is preserved? We still do not know
when to expect greater benefits of psychotherapy
alone, medications alone, or their combination, but
at least now we have a conceptual basis for using both
of them and even for combining them, since the two
approaches converge neurobiologically. These and
many more questions will form the research agenda
for moving this approach forward as a central aspect
of clinical therapeutics in psychiatry.
The best psychotherapy candidates to combine
with drugs, particularly for the treatment of depression, are cognitive behavioral therapy and interpersonal therapy, which are often conducted by
therapists who have read a training manual, been
supervised administering it to patients, and who use a
12- to 24-week approach that follows a progression
with a beginning, a middle, and an end. The new
“trial-based therapy” described by de Oliveira is a
version of cognitive psychotherapy that is intuitive,
readily adapted by psychiatrists who are not necessarily sophisticated cognitive behavioral therapists, and
can even be fun. In trial-based therapy the patient
literally puts his psychiatric symptoms and core beliefs
on trial. This idea is based on the universal principle
portrayed in Franz Kafka’s The Trial that human
beings by their very nature are self-accusatory and this
can lead to confusion, anxiety, and existential
suffering. In fact, the central character of this novel,
Joseph K, was arrested, put on trial, and convicted
without ever knowing the crime of which he was
accused. De Oliveira’s technique is to take this universal truth and fit it into a modern courtroom paradigm.
Here, during outpatient psychotherapy, a patient’s
self-accusations are put on trial as distorted schemas
and core beliefs that have been developed about the self
by the patient’s “inner prosecutor,” who convinces the
patient that these beliefs are true, and because of this
the patient suffers. Trial-based therapy seeks to point
out to the patient that his symptoms and suffering are
due to core beliefs that can be countered by activating
his/her “inner defense attorney” to see things in a more
balanced and realistic way and thereby relieve symptoms. One could hypothesize that, when successful,
this approach is forming a synapse of the new perspective of the “inner defense attorney” to counter and
inhibit the circuit mediating the activation of the first
learning, namely the distorted core belief of the “inner
prosecutor.” Trial-based therapy is only one of the
potential psychotherapies to combine with antidepressants for the treatment of major depression and to take
us beyond the current plateau of pharmacotherapy.
Combining psychotherapy with antidepressants has
the potential of making the entire outcome greater
than the sum of the parts, or 1 + 1 = 3, the delightful
“bad math” of therapeutic synergy.
Mogę też polecić książkę "Neuronauka w psychoterapii" (L. Cozolino).
Problem z psychoterapią jest taki, że trudniej o standaryzowane badania. Można wyprodukować tysiące tabletek o identycznym składzie, natomiast oddziaływania terapeutyczne są niepowtarzalne (nawet jeśli prowadzone w jednym nurcie).
Post trochę odbiega od tematu wątku. W razie czego zgadzam się na wydzielenie czy coś.