Let's not louse it all up ... (draft, long)

I want to open with a disclaimer that I'm not wanting to bash psychotherapy or psychiatry in general.

Long post, just something I've been wanting to write down in detail for quite some time.

tl;dr> just listen to or read Dr. Bob's last talk, and maybe I'm being grandiose in writing all this out when Bob said it so much more simply and beautifully :)

We know but few instances where we have given these doctors a fair break.

^(Reprinted from "Alcoholics Anonymous", page 73, with permission of A.A. World Services, Inc. - https://www.aa.org/the-big-book)

I also have no doubt that many of us suffer from grave emotional and mental disorders, some that Alcoholics Anonymous cannot completely address (though for many or most, adopting the A.A. principles can, I think, help mitigate these disorders.)

Doc Bob said:

There are two or three things that flashed into my mind on which it would be fitting to lay a little emphasis. One is the simplicity of our program. Let's not louse it all up with Freudian complexes and things that are interesting to the scientific mind, but have very little to do with our actual A.A. work. Our Twelve Steps, when simmered down to the last, resolve themselves into the words “love” and “service.” We understand what love is, and we understand what service is. So let's bear those two things in mind.

— from https://www.aa.org/dr-bobs-farewell-talk

I stumbled into a New York Times Op-Ed a few weeks ago, and many of it's assertions rang true - https://www.nytimes.com/2023/08/10/opinion/trauma-mental-health-culture-war.html - it begins:

If I were asked to trace the decline of the American psyche, I suppose I would go to a set of cultural changes that started directly after World War II and built over the next few decades, when writers as diverse as Philip Rieff, Christopher Lasch and Tom Wolfe noticed the emergence of what came to be known as the therapeutic culture.

In earlier cultural epochs, many people derived their self-worth from their relationship with God, or from their ability to be a winner in the commercial marketplace. But in a therapeutic culture people’s sense of self-worth depends on their subjective feelings about themselves. Do I feel good about myself? Do I like me?

From the start, many writers noticed that this ethos often turned people into fragile narcissists. It cut them off from moral traditions and the normal sources of meaning and identity. It pushed them in on themselves, made them self-absorbed, craving public affirmation so they could feel good about themselves. As Lasch wrote in his 1979 book, “The Culture of Narcissism,” such people are plagued by an insecurity that can be “overcome only by seeing his ‘grandiose self’ reflected in the attentions of others.”

Lasch continued: “Plagued by anxiety, depression, vague discontents, a sense of inner emptiness, the ‘psychological man’ of the 20th century seeks neither individual self-aggrandizement nor spiritual transcendence but peace of mind, under conditions that increasingly militate against it.”

A lot of my sympathy with these ideas comes from personal experience with psychiatry.

In the mid or late 1990s, it was suggested that I might 'suffer' from some mild depression. Part of this came from a visit to my mom one state northward. She had always had tendencies toward glumness, always had had a somewhat hard life, and she shared that she had started taking a supplement containing (or perhaps entirely consisting of) St. John's Wort and reporting that it had raised her spirits considerably.

It was later suggested that I might similarly benefit, and so I tried it out. I don't recall details of the experience after taking it for some weeks/months, but I think it brought about some general heightened elation. So it was later suggested that I see a psychiatrist for some more precisely formulated antidepressant medication. (These 'suggestions' were coming from my wife and her/our therapist.)

I ended up taking antidepressants for something like 8-10 years - specifically Celexa at first and later Lexapro. It was only after being on these drugs for a while that my drinking started to become excessive. Prior to this, I'd essentially been a normal, moderate drinker for a couple of decades. The escalation from occasional heavy drinking to page 21 type "always more or less insanely drunk" progressed very slowly.

In the early months of sobriety, probably somewhere between Steps 4 and 7, I came to question my use of antidepressants. Were they really doing anything for me? I pretty well thought "not" having formed an opinion that I'd never suffered from 'depression', that in my case, it was simply self pity.

I sought out the best local psychiatrist that I could find, someone of very high repute. In hindsight, the psychiatrist who had prescribed the antidepressants was rather unprofessional. His consultations were little more than, "How ya feeling? Try these pills!" (That's an exaggeration, but not by much!) Years later, I learned that he had been subject of a criminal investigation for being too generous about writing up prescriptions, and as part of a plea settlement he had agreed to revocation of his license to practice.

In contrast, this new psychiatrist spent quite a long time doing a rigorous exams with very specific and pointed questions. His conclusion was that antidepressants were inappropriate for me, which was what I was pretty much expecting/wanting. He had me taper off the antidepressants over a period of several weeks.

Another conclusion was quite startling! He said that the antidepressants quite possibly have been an influence in nudging me toward excess drinking, that these antidepressants sometimes (often?) had a side effect of "hypomania" which I understand is a mild form of mania. It really rang true to me as under their influence I occasionally experienced brief periods of rather extreme elation, sometimes accompanied by feelings of grandiosity. He said that in drinking I was likely subconsciously trying to settle down this mania.

I guess I also Judge today's society as being overmedicated and have a strong inclination to find the NYT article "correct" (though I hope I'm sufficiently humble about it.)

Particularly in these recovery forums I see so many people airing complaints of ADHD, OCD, Anhedonia, Neurodiversity, blah-blah, blah-bah!" Sometimes it makes my head dizzy.

And then I see what appears to be a rather excessive number of people on various amphetamines and other psychiatric drugs, and I wonder if that's a good approach, thinking that just plain old talk therapy, behavioral therapy, and 'spirituality' (whatever that means ... I'm still not sure - dense about it I suppose) might server better.

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Lastly (and perhaps SAVE THIS FOR A COMMENT) I'll share a story of a sponsee.