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A Study In This Month's Journal Of Nervous And Mental Disease Reveals Hope For Recovery From Suicidal Thinking And Treatment Resistant Mental Illness
Date:1/15/2009

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One glimpse of Riggs' success comes in its use of medication, which is coordinated by the psychiatric, psychotherapeutic, and nursing staffs to attune with a patient's history and needs. This stands in sharp contrast to standard operating procedure. Most psychopharmaceuticals are dispensed by general doctors. Even patients seeing a psychiatrist often spend little time in conversation, let alone developing a real relationship. But the evidence shows that relationships matter. "The most powerful part of a pill," says Dr. David Mintz, Austen Riggs' director of residency training, "is the meaning that's attached to it and the relationship that goes along with it." One NIMH-funded study found that patients taking a placebo, but who had a good alliance with their doctor, actually got better than patients with a poor therapeutic alliance who received an active drug. Indeed, the relationship had an effect seventeen times more potent than the drug itself. Even the much discussed placebo effect -- where patients respond to a sugar pill -- is often misunderstood as negligible, when in fact it is quite real, biologically, and often springs from real factors -- like a patient's willingness to change, or her trust in a doctor. In any case, no drug can help if a patient neglects or refuses to take it, which happens in the culture at large 50 to 70 percent of the time, depending on the diagnosis. At Austen Riggs, by contrast, non-compliance rates run from 10 to 21 percent.

After stays that last a median 8 months at Austen Riggs, in many cases, people's lives are transformed. "When things have gone well," says Dr. Plakun, "patients have found an authentic voice and have often gained access to the complexity of their own feelings, so that what looked like 'treatment resistant depression' for example, now is experienced as a mixture of grief and rage that they can link to their personal life narratives. They can acknowledge, bear it, and put the feeling
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SOURCE Austin Riggs Center
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