January 24, 2007
South Beach Diet and Psychotherapy
Neill Neill, Ph.D.
I just read a disturbing article in the New York Times, disturbing because its implications go far beyond the scope of the article.
The article is entitled, "What’s a Pound of Prevention Really Worth?" by David Leonhardt. He talks about a cardiologist who characterizes himself as "an accidental diet doctor." Dr. Arthur Agatston of South Beach Diet fame now claims that "Heart attacks are essentially disappearing from my practice."
The big picture of what he is saying and taking action on is simple. We know many of the factors that prevent heart attacks, both medical and lifestyle, so a vigorous prevention program reduces the risk by "up to 80 percent."
The problem is it takes a committed patient, frequent visits, nurses, nutritionists and others to succeed.
And according to the article his practice is losing money. Why?The answer lies in the fact that the whole health-care system, including its financing, is geared toward physician intervention, not multidisciplinary prevention.
Hardly anyone disagrees anymore that psychological problems go hand in hand with physical diseases. The only thing that’s changing is that the broadening range of physical diseases with at least partial known, psychological origins. No one argues anymore about the links between emotional distress and heart attacks.
Decades ago I came across a large-scale study about the effects on general heath of a psychological intervention. If I recall correctly, they found that people who went to a psychologist for a single visit had over 50 percent fewer visits to their family physician over the next five years. Wow!
But the health-care systems, public (Canada) or private (USA) typically pay only for the medical treatment, not the psychological.
Yes, modern medications for depression, for example, will probably give you relief and make life more livable. But they do no help you address the underlying emotional/mental/spiritual problems. In fact, in some cases, they sufficiently mask the problem that you postpone facing it.
Recent research suggests that depressed patients are more at risk of heart attack than normally happy people, and if they do have a heart attack, their long-term survival rate is substantially lower.
My conclusion is that treating the causes of depression, not only reduces the risk of recurrence, but also is a preventative step in heart health and longevity.
Why not address both treatment and prevention? Why not address the immediate problem with medication and psychotherapy to help you clear the causes of the depression? This is basic practical psychology.
It usually comes down to money. Your health-care plan pays for the pills; you pay out of your own pocket for the psychologist’s fees.
So just as the heath-care systems keeps the cardiac-risk patient away from preventative services and funnels him or her into straight medical treatment, so it funnels the person with an emotional problem into medical treatment alone.
I think there’s something wrong with this picture. What do you think?
Neill
Dr. Neill Neill
Practical Psychology for Capable People
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3 Comments »
Dr. Lisa Ann Homic :
I agree with you. I was a therapist in a community mental health center working with the chronically mentally ill and these folks were falling through the cracks. The psychiatrists sent our clients to their physicians whenever they had a physical complaint and then the physicians sent them back saying they had nothing physically wrong with them. I worked on their self esteem and coping skills trying to reframe their self-defeating behaviors. Many were diet coke, carb, and nicotine addicts. But they truly believed their brains were defective so it was very difficult to get them to think beyond their medications. I turned my attention to chiropractic as a drug free intervention that benefits the mind and body connection. **I found your site via your testimony on welcomechanges.com Take care Dr. Lisa
Dr. Neill Neill :
Thank you, Dr. Lisa, for your comments. Although I didn't mention it in my article, I too have had clients make significant breakthroughs when I had them work with a good chiropractor while they worked with me.
Good medical treatment is essential, but thinking beyond the medical model truly expands the healing possibilities. Blessings, Neill
Nancy :
Hello Neill, I really miss seeing you, and reading a whole series of your articles tonight has been uplifting. Psychotherapy being both preventive and curative to many conditions of body mind and soul, I wish that it were acknowledged as such in supportive payment from government health sources. Through our work together I was helped through several crises. Now I am really interested in getting at the underlying issues that I continue to use to keep myself from acting out in my life from the more highly evolved love state, rather than the fear state. You’ve encouraged me to make changes. Some changes are happenning slowly. There was a particular article in this series on anger that was also helpful. I’ll watch how anger can be an instrument towards positive change. Here’s to Nancy coming out of the box! Today my t’ai chi chuan teacher asked if I would teach if she neds to be away. I looked around as if she might be addressing someone else! Claim some of that spirit Nancy, I say. My friend in Toronto again referred to marriage. Perhaps we do have a groundwork of thirty years that can address some of these recent issues of mine and bathe them in forgiveness and allow for getting on with what’s important. Miracles do happen. They have happenned before in my life. I am open to the new. Neill, I hope I can in some way see you again soon. I am studying more full body massage technique and becoming more proficient there, and gentle touch is part of that.