THE BLOG
03/07/2011 11:44 pm ET Updated May 25, 2011

Help Me Talk My Way Out Of It

I'm a little anxious today about an article in the New York Times.

Apparently, trained psychiatrists in this country are being reduced to dispensing medication in 15-minute sessions because of insurance coverage. Dr. Donald Levin is quoted in the New York Times that years ago he saw patients 10 or more times before arriving at a diagnosis. Now he makes that decision in the first 45-minute visit. "You have to have a diagnosis to get paid," he said with a shrug. "I play the game." Part of the "game" is to prescribe medication on a snap decision. Thanks a lot, doc. So glad to hear you're doing well. What about the rest of us mortals? Patients need to talk it out with you or someone in your field. We need to laugh and cry and get to the bottom of why we're so anxious and scared and depressed and just plain old miserable.

The talking cure, as it is known, has been my salvation. I would not be in the position I am in both professionally and personally if it were not for my years on the chair and/or the couch. I was a worrier and an underachiever for many years. Like many women, I was closer to what Karen Horney referred to as a "self-effacing personality" rather than a grandiose or "expansive" personality (there are tons of those in my profession). Without therapy, I would have continued to be unsure of my instincts and talents. Think Gaddafi versus Mr. Peepers and you might get a clearer picture of what I'm describing.

Maybe I don't understand health insurance. Does anyone? I've always been perplexed by the fact that dental coverage was separate from regular health insurance and that many people are not covered for dental work. Are teeth and gums not part of our anatomy? Do they not bleed like other parts of our bodies? Eye exams are covered and so are hearing issues, but when it comes to teeth, all bets are off. What have these companies got against masticating?( I hope the Tea Partiers are not reading that word incorrectly.)

The issue is similar when it comes to mental health. Apparently all the research on mind/body connections become irrelevant when it comes to covering something as important as how we get through the day in one piece. I'm not putting down medication. I believe it has helped many people out of chronic depression and anxiety, but unless you know what is causing these symptoms, you probably will not achieve what psychiatrists and psychologists consider the worthy goal: to become happy and fulfilled.

Maybe just eliminating anxiety is enough for some people. Certainly no one wants to remain anxious or depressed. I know I didn't. But when it comes to the Freudian principle that the goal of psychotherapy is to allow the patient to love and work, medication without talking is only half the job. And anyone who knows me knows that I love to talk.