Effectiveness of psychoanalysis for depression
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- Опубликовано: 8 сен 2024
- We close the series on the effectiveness of psychoanalysis with one example: how does it help when it comes to depression?
Nicolas Lorenzini is a Clinical psychologist, MSc in psychoanalytic studies, Ph.D. in psychology. Psychoanalytic psychotherapist in Berlin. Postdoctoral Research Fellow at University College London. Lecturer at the International Psychoanalytic University Berlin. Assistant to Professor Peter Fonagy.
Psychoanalysis should be free! From this motto, we're looking at making the insights of more than a century of psychoanalytic understanding available to everyone and everywhere.
To help us produce more videos like this, do support us through our Patreon page: / berlinpsychoanalytic .
Great. It is sad that there are people who thinks psychoanalysis is a pseudoscience because they ignore how much it is complex this discussion about what makes a psychotherapy works and what does it mean for a therapy to work.
If after more than 100 years people trained in psychoanalysis stiil don't know "what cures" (and how) - there's room for some measure of healthy scepticism.
This is fascinating. Thank you so much for starting this channel. I look forward to your new videos in my feed most of all!
Thanks, wendelinw, for this supportive message. There are more new videos to come.
love the perspective shared here, particularly in regards to societal cost!
Thank you for your support!
Truly outstanding videos, for someone like myself who is looking to get into this field this was extremely informative and thought provoking! 😀🙏
Thanks a lot for the feedback! We are glad to be of help!
I would love sources on the studies you mention. Great video.
Thanks for the question. I leave some of the sources here:
General findings concerning efficacy:
van der Lem R, de Wever W, van der Wee N, van Veen T, Cuijpers P, Zitman F: The generalizability of psychotherapy efficacy trials in major depressive disorder: An analysis of the influence of patient selection in efficacy trials on symptom outcome in daily practice. BMC Psychiatry 2012;12:192.
Cuijpers P, Hollon SD, van Straten A, Bockting C, Berking M, Andersson G: Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open 2013;3
Driessen E, Cuijpers P, de Maat SCM, Abbass AA, de Jonghe F, Dekker JJM: The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis. Clin Psychol Rev 2010;30:25-36.
Evidence-Based Psychotherapies for Depression
Hollon SD: Cognitive and behavior therapy in the treatment and prevention of depression. Depression and Anxiety 2011;28:263-266
Driessen E, Cuijpers P, de Maat SCM, Abbass AA, de Jonghe F, Dekker JJM: The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis. Clin Psychol Rev 2010;30:25-36.
Cuijpers P, Geraedts A, van Oppen P, Andersson G, Markowitz JC, van Straten A: Interpersonal psychotherapy for depression: A meta-analysis. Am J Psychiatry 2011;168:581-592
Elliott, R, Greenberg, Leslie S., Watson, et al (2013) Research on humanistic-experiential psychotherapies. In: Bergin & Garfield‘s handbook of psychotherapy and behavior change. John Wiley & Sons, New York, pp. 495-538 .
Asen E: Outcome research in family therapy. Advances in Psychiatric Treatment 2002;8:230-238.
Publication Bias and Methodological Criticism:
Westen D, Novotny CM, Thompson-Brenner H: The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials. Psychol Bull 2004;130:631-663
Luyten P, Blatt SJ: Integrating theory-driven and empirically-derived models of personality development and psychopathology: A proposal for dsm v. Clin Psychol Rev;31:52-68
Cuijpers P, Smit F, Bohlmeijer E, Hollon SD, Andersson G: Efficacy of cognitive behavioural therapy and other psychological treatments for adult depression: Meta-analytic study of publication bias. The British Journal of Psychiatry 2010;196:173-178.
Cuijpers P, van Straten A, Bohlmeijer E, Hollon SD, Andersson G: The effects of psychotherapy for adult depression are overestimated: A meta-analysis of study quality and effect size. Psychol Med 2010;40:211-223
Long-term vs short-term psychotherapy
Piet J, Hougaard E: The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysis. Clin Psychol Rev 2011;31:1032-1040
Leichsenring, F., & Rabung, S. (2011). Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis. The British Journal of Psychiatry, 199(1), 15-22.
Luyten P, Blatt SJ: Psychodynamic treatment of depression. Psychiatr Clin North Am 2012;35:111-129.
Cost-effectiveness:
Abbass, A., Driessen, E., & Town, J. (2011). Cost-effectiveness of intensive short-term dynamic psychotherapy. Manuscript submitted for publication.
Berghout, C. C., Zevalkink, J., & Hakkaart-Van Roijen, L. (2010). The Effects of Long-Term Psychoanalytic Treatment on Healthcare Utilization and Work Impairment and Their Associated Costs. Journal of Psychiatric Practice, 16(4), 209-216.
Berghout, C. C., Zevalkink, J., & Hakkaart-van Roijen, L. (2010). A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy. International Journal of Technology Assessment in Health Care, 26(1), 3-10.
de Maat, S., Philipszoon, F., Schoevers, R., Dekker, J., & De Jonghe, F. (2007). Costs and Benefits of Long-Term Psychoanalytic Therapy: Changes in Health Care Use and Work Impairment. Harvard Review of Psychiatry, 15(6), 289-300.
Psychotherapy vs. Psychopharmachology
Cuijpers P, Van Straten A, Van Oppen P, Andersson G: Are psychological and pharmacologic interventions equally effective in the treatment of adult depressive disorders? A meta-analysis of comparative studies. J Clin Psychiatry 2008;69:1675-1685.
Cuijpers P, van Straten A, Schuurmans J, van Oppen P, Hollon SD, Andersson G: Psychotherapy for chronic major depression and dysthymia: A meta-analysis. Clin Psychol Rev 2010;30:51-62.
Cuijpers P, Hollon SD, van Straten A, Bockting C, Berking M, Andersson G: Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open 2013;3
Cuijpers P, Dekker J, Hollon SD, Andersson G: Adding psychotherapy to pharmacotherapy in the treatment of depressive disorders in adults: A meta-analysis. J Clin Psychiatry 2009;70:1219-1229.
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I hope this is useful. It is always possible to find updates to these references, but when trying to use reviews and meta-analyses, these ones have been so far replicated. Let me know if you find contesting evidence, I'd really appreciate that.
thanks for this scientific and great video. this is the most problem between the real psychotherapy i mean the Freud's Heritage named Psychoanalysis and the CBT or others... . i think this video can challenge the APA's thoughts and DSM! Danke! - Alireza Eiv, Ein psychologiestudent im Iran.
Hi Alireza! Thank you for your feedback and good luck with your studies!
Even though i have not gone to a professional ive read countless books and more articles about psicoanalysis especially on the jungian school of tought and with the help of the way he understands how the human mind works and different resources ive partaken into like: self help, stoicism philosophy and a change in lifestyle, i have been successful in delving deep in my mind and trying to understand my self to deal with all of the things i have struggled with mentally like depression (especially worsened by covid) and as a result im living a happier and healthier life :)
Compare to ketogenic diet.
I had heard many years ago that psychoanalysis, with a typical focus on the past, will be negative for people with depression. This was due to depression being typically already a negative past-oriented view. Is this true?
Out of interest with the above, can you cite a study that shows analysis working with depression? I’d like to read it.
Thanks!
I don’t see the pathway to resolving depression as positivity. I see it as authenticity. People need to feel what they need to feel, not block it out.
J I didn’t mention positivity, but certainly possibility and hope. Many are already feeling their suffering ‘authentically’ (also a very Western concept). Many will have a very intimate relation with their pain already.
I think the issue is changing the processes and allowing a new experience to evolve, which requires a new shift in perspective and resources.
Psychoanalysis does not mean dwelling in the past forever, it means understanding the past in relation to the current situation, so that the patient can grow emotionally and let go of the past. Psychoanalysis means understanding the past and oneself better and being able to grow into a stronger and healthier person for it. In comparison to cognitive behavioral therapy it digs far deeper, but is also able to produce more extensive changes in patients. The rate of remission and even increasing well-being over time is higher (especially long term, as in 5 or 10 years) than in cognitve behavioral therapy. You can use google scholar to find quite a few studies on this from England and the US.
@@user-xy4ff5yp7bNeurobiology unfortunately doesn't care about your pseudo-semantics!
@@mistypotato7500Psychoanalysis means nothing, because it's all made up nonsense without any fact base.
This video is excellent, can I ask you how strong is the presence of psychoanalysis in your country?
Most of the empirical findings presented are from the US and Europa (UK mostly). Dr. Lorenzini's country of origin is Chile, where psychoanalysis is important in the training of all psychotherapists as a reference. But there's no publicly funded psychoanalytic initiatives.
it is psycoanalysis effective for social anxiety/depersonalization?
Psychoanalysis is esoteric nonsense, unless of course you believe that the Oedipus Complex is a valid scientific concept.
I stopped watching after 2 minutes because of the bullshit statement that without treatment 100% of the patients would stay depressed. First of all, almost nothing is 100% in psychiatric disorders. Furthermore without ANY treatment a depressive episode lasts on average 6-8 months! Ofc the longer the duration of the psychotherapy, as is in psychoanalysis, the higher the probability that a remission will occur in this time, resulting to false positive results. Also if you refer to a study in a video you should present it or at least put a hyperlink so that we can judge its quality. I guess you do have a personal interest to exaggerate the efficacy of psychotherapy but i do hope your SUPEREGO might feel some shame for misinforming, intentionally or not, with such confidence loool. At least dont tell your patients those statistics, either psychotherapy or 100% you will stay depressed.......
These guys are promiting a hoax for personal financial gains, yet they pretend to be progressives.
Superego doesn't feel shame. Superego generates shame.
Why is Rosa on the channel icon?
Rosa Luxemburg and Berlin Psychoanalytic share the relation to Berlin and our underlying social ethos.
@@BerlinPsychoanalytic Nice!
@@BerlinPsychoanalyticThat's funny, because Psychoanalysis was prohibited by the comrades in East Germany, the very same state that named public places after Luxemburg and Liebknecht and even held an annual holiday in remembrance of both.
😍
Psychotherapy works, Psychoanalysis DOES NOT! Also 1:54 this is totally incorrect. There is a significant rate of remission even in patients who don't receive treatment! In fact Kirsch showed that remission under placebo treatment is almost equivalent to the best drug treatments currently known. Placebo is essentially no treatment (one can differ philosophically, but not materially).
That is false. Psychoanalysis has the same efficacy as CBT
@@kw1ksh0tOf course in the short term any activity that grants a depressed person an opportunity to talk with a supportive person in an intimate setting of trust, will help. This is not an effect of therapy, but of the interpersonal interaction that therapy enables. You would get the same effect if a depressed person had the opportunity to talk to a friend they trust, only that in therapy they pay someone to regularly provide this setting.
The underlying theories of CBT and especially Psychoanalysis are of course total BS. Therapy works despite these theories, not because of them!
@@esahm373 You are talking too much in absolutes. "Psychoanalysis does not work" - false, for some it surely doesn't, and it may also not be the first course of action. But approaches like CBT don't work for a very high percentage of depressed patients either. He also talks about such long-term treatments (like a long-term psychoanalysis) might be more applicable to people with severe or chronic depression. You can also find some studies comparing CBT and Psychoanalysis for example, where you can see that psychoanalysis shows slower improvements over time compared to CBT, but over long periods of time will catch up and even potentially surpass CBT in such cases.
"any activity that grants a depressed person an opportunity to talk with a supportive person in an intimate setting of trust, will help" - no. Not everybody is simply requiring a setting of trust or support to feel better to at least some extent. Especially you comparing therapy with a regular conversation with a friend.
@@leyren2606 Absolutes are indicated in some scenarios. Psychoanalysis has no solid foundation and lacks evidence base and a reproducible mode of explanation.
It's completely built upon subjective philosophical proposals that were initiated by often questionable personalities, who are more alike gurus of a pseudointellectual cult than proper researchers.
Making up sophisticated sounding models that claim to explain the innerworkings of our minds and recycling antiquated terms like "Oedipus" and "Narciss" does not make someone a prooer scientist, but rather makes someone a snake oil salesman!
@@esahm373So you think there is no unconscious part of the mental apparatus that influences the conscious part? Oh wait. You don't even believe a mental apparatus exists, since it cannot be measured. Do you think your mother loves you? Apparently not, since it can't be proven scientifically.
Don't get me wrong. It is important to test hypothses empirically but saying that anything that can't be measured doesn't exist is obviously intellectually dishonest. And please don't try to say we can empirically test love by measuring oxytocin or some other reductionist bullshit.
you can't measure... what are you talking about?
WRONG! Psychoanalysis is becoming obsolete because it takes too long to start bringing results and therefore more expensive, CBT is the way to go now. Time to get on with the modern times.
Dear Yash, it seems like you are talking about different things. While Nicolás talks about scientific evidence, you seem to refer to the current societal trends (especially in the US?), where time and money are often the crucial parameters. So, you may both be right in your own ways, right?
CBT is gas-lighting.
@@BerlinPsychoanalytic love this response
@@alisher1984 Isn't every type of individual mental health approach "gas-lighting"?