Posted by Pfinstegg on December 19, 2002, at 10:13:08
In reply to Re: next steps - Anna Laura, posted by Anna Laura on December 19, 2002, at 7:28:25
I have read that psychoanalysis is pretty active in Italy, and obviously not always in a particularly helpful way! It seems to have fallen into disfavor here, and is generally considered to be a dinosaur. However, I have recently been finding out that it is getting resurrected here in a more up-to-date manner, under names such as relational psychoanalysis and attachment disorders theory. They are utilizing research on infant development done at great places like the Yale Child Study Center, and are also finally paying attention to the research on changes in brain development, neurotransmitters and endocrine function which occur during severe stress. I just read an article last night in a new journal called "Psychoanalytic Dialogues" in which Borderline Personality Disorder is identified as a particular form of PTSD occurring in childhood- what an advance in thinking!
Having had that diagnosis my entire life, I know it is the "diagnosis from hell". Doctors hate it, and think that you can never get better. However, I am proof that you can get a lot better with an interactive type of psychoanalytic therapy, which can replace some of the absent mothering, and also help you learn to deal in a calmer way with physical and sexual abuse. Before that therapy, I was in so much difficulty- getting involved in one sexual relationship after another, none of which were "right" or were able to modify the inner pain I was continually experiencing. Afterwards, I was so much calmer and happier, with many fewer episodes of severe emotional pain- and I felt that I had resources to deal with those episodes when they occurred. I was able to marry a great guy, and develop a satisfying career in which I felt I was really using my abilities well. I had energy to develop skills and interests, such as painting, botanical photography, mountain-climbing and horseback riding (dressage). I was able to raise a healthy son, who is now starting his own life- about to get his PhD in physics, and engaged to a wonderful girl. I think I can say that the generational cycle of pain and abuse really did stop with me. So, from my point of view, the right kind of interactive, relational psychoanalytic psychotherapy can be life-transforming. Don't let a diagnosis get to you- they are all out-of-date, anyway- and NO couches! Therapy needs to be face-to-face, and the analyst needs to be trained in the new way.
As much pain and hopelessness as you are enduring right now, try to remember that YOU can make the correct choices for yourself- you can ask for the synthroid (levothyroxine) and Cytomel (triiodothyroxine) supplementation, but you don't have to take any AD that you have a lot of doubts about. Over the last five months, I have relied on levothyroxine 0.05 mg. , triiodothyronine 5mcg. and enough fish oil to get 1 gm. of EPA daily, having stopped Prozac, Paxil, Wellbutrin and Zyprexa. I also take Tianeptine, a European tricyclic; it is not a strong AD, but has been shown to protect the hippocampus from damage from excess cortisol. Having had an MRI, I know that my left hippocampus and left pre-frontal areas are about 20% smaller than normal- the effect of too much stress hormone over a lifetime. Having looked, I know that I have HPA axis dysregulation by now- my hippocampus is supposed to tell my hypothalamus to down- regulate the production of CRH (Corticoid-Releasing Hormone), but it can no longer do that. It is also supposed to tell my hypothalamus to down-regulate the output of TRH (Thyroid-Releasing-Hormone), but it can't do that any longer, either. That is the rationale behind thyroid supplementation- it sends a stronger message to the hypothalamus to down-regulate; the triiodothyronine also has an antidepressant effect by itself. As you know, there isn't yet a CRH-antagonist anywhere near ready for use, although there are some in Phase 2 studies. For the most severe depressions, where the 24-hour urinary cortisol is above normal, there are very active studies using mefipristone in the US at Stanford and NIH. It is apparently very effective, and has been fast-tracked by the FDA. It's a short-term treatment- if it going to work, it apparently does so within a week, but I'm not sure what happens afterwards- it works by rapidly lowering cortisol levels to normal, but, would they stay there?
As you make your way through the system, don't forget that YOU are in charge of your own health, and YOU get to make the informed decisions!
Wishing you they very best...
Pfinstegg
poster:Pfinstegg
thread:33204
URL: http://www.dr-bob.org/babble/social/20021218/msgs/33633.html