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professional opinion
May 8, 2008

Dear Dr. Bob,

I have known you for years to be a down to earth person who believes in science.

I have been HIV positive for 3 years. People around me think i'm strong and heroic. I'm not! I'm now one step away from complete mental collapse. I have stood up and fought very hard the past three years and now I can't do it anymore..I need help. Besides having HIV, I have also bipolar II.

My Shrink in europe who (unlike the US) is only concerned with medications and medical issues thinks it is time for me to see a Phsycotherapist.

I have never believed in phsycotherapy and I'm not sure this is the thing for me. A Shrink is different, he gives you medication, he is a real doctor if you will. On the other hand a physcotherapist to me was not a real doctor! I have no experience whatsoever with this thing and I do not want to get into it and turn back disappointed or wasted.

My question to you is twofold: 1- What is your professional opinion about physchotherapy techniques like hypnosis or CBT etc. is this true science? is the whole field science indeed? 2- If you think I should go, what should be my attitude, how do I need to deal with this therapist? aka. what to expect and after how long should I see what I expect? any quantifiable measures?

Your advise is much appreciated. I've never lost a fight and I do not want to lose this fight. I want to regain the old me back and just put HIV in perspective.

Response from Dr. Frascino

Hi,

Yep, I'm down to earth and yes, I do believe in science. As it turns out I also believe in psychotherapy! You are correct: Psychiatrists are MDs and therefore have been through medical school and residency and can prescribe medications. That, however, doesn't diminish the work that can be done by a licensed psychotherapist. "Talking therapy" is a very valid and scientific treatment modality when done correctly. Often times psychiatrists work closely with psychotherapists. Medications are one way to help with conditions like depression, mania, bipolar disorder, anxiety, etc. And talking therapy is another. The two often are used in tandem. To specifically address your questions:

1. Psychotherapy is indeed "true science" and can be highly beneficial. I would get a recommendation or two from your psychiatrist of psychotherapists with whom he works closely and meet with them. Give them a chance! It's certainly not going to hurt.

2. What should your attitude be? It should be that the therapist you are seeing is a professional who could significantly help you! What should you expect? I can't answer that specifically. Why not ask the therapist exactly how he or she might be able to help and also what you should expect from the sessions? As for quantifiable measures, I say "feeling better." At this point you report being "one step away from complete mental collapse." So if the therapy helps you cope and regain control as well as perspective, I'd say it would be well worth the effort. I urge you to give it a try!

Dr. Bob



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