Words that heal; thanks Natalia Pasternak and Carlos Orsi – 08/25/2023 – Luciano Melo

Natália Pasternak raised the discussion on facing the Covid-19 pandemic, in opposition to hostile pressure and shallow ideas, which should not be, but are in recent history.

She is once again on the scene due to the provocations left in her new book “What nonsense! pseudosciences and other absurdities that do not deserve to be taken seriously”, also signed by Carlos Orsi. In the work, the authors argue that psychoanalysis, acupuncture, homeopathy and other compilations of thoughts are pseudosciences, with arguments based on evidence. The bold language prompted criticism, particularly from many who care for psychoanalysis, at least that’s how I perceived it. The book is an invitation to debate. If you disagree with the conclusions drawn, prove your point.

I will counter-argument the couple with evidence, following a method. I sent messages to my psychiatrist friends, with direct questions: do you believe in the effectiveness of psychotherapy, yes or no? Do you conduct psychotherapy?

I created a score: one point if the psychiatrist does not act as a psychotherapist but agrees with the benefits of the practice; half a point if you agree and act directly with the intervention. A negative point if you believe that psychotherapy is a waste of time.

Unfortunately, many disregarded my poll. In the end, out of 32 defendant psychiatrists, only 14 psychiatrists participated. The final score, 8. All respondents were in favor of psychotherapy. Only two did not work as psychotherapists, one of them works exclusively as an expert, and another divides his activities between prescription and medical research.

I have, therefore, evidence in favor of psychotherapy: I scientifically measured the opinion of experts, that is, of doctors who treat diseases of the mind. And I didn’t need to write epistemology, hermeneutics, Emmanuel Kant, Augusto Comte. But I will remind you, essential reader, that expert opinion as evidence is the weakest evidence there is. Although it is often a doctor’s only support in making a decision. Besides, my method is bad, without statistical treatment and based on a small sample.

Suppose my name was Franz Ferdinand and I was a full professor of psychoanalysis at the Hypothetical University of Graz, and I had a friend named Gavrilo Princip, head of the same discipline at the Imaginary Faculty of Obljaj in Bosnia. In that case, I could do something much better.

It would be possible to associate with my colleague to homogenize our discipline across borders, assess our students’ knowledge and characterize fundamental skills to be mastered by all those psychoanalysts we train. So, in a place where there is suffering, we could measure the impact of our psychoanalytical methods and compare it with the effect of other practices that we do not guide, such as religious support, physical or artistic activities.

Independent researchers would enumerate numbers of suicides, arrests, violence, substance abuse, divorces, job tenure. They would quantify dropouts and find out the reasons for dropping out.

A job that makes you tired just thinking about it. Risky, however consistent with the challenge of dealing with mental health. Without having to write epistemology, hermeneutics, Emmanuel Kant, Augusto Comte, could bring proof that the couple composed of Natália and Carlos defy. Or review my method for correcting errors. Either way, it would bring advances that we humans need. Proving something scientifically is often not elementary, and it almost always requires tremendous effort.

Certainly, you, attentive reader, must be almost giving up reading me, because you have already noticed a mistake that I have been making. But I will fix it before you give up. I used the terms psychotherapy and psychoanalysis without explaining that they are not synonymous.

Psychoanalysis can be defined as a theory, not a technique, which had Sigmund Freud as one of its founders. Different techniques are applications of this theory, thanks to the fragmentations and dissidences of Freudian conduct. As a result, different schools have different ways of linking concepts to practice, a complication that blurs psychoanalysts’ claim to obtain scientific status for their action. Alternatively, psychoanalysis can be understood as the primordial form of psychotherapy, which advocates free associations for interpretations of speeches, desires, memories and dreams, with the aim of reaching the root of psychic suffering, internalized conflicts, between consciousness and the unconscious. . Freud was not careful to seek scientific rigor for these ideas of his. But he taught his students to listen calmly and attentively to patients as never before.

Psychotherapy, in turn, is a broader term, it is talk therapy, the dialogue between therapist and patient. And words heal. The movement that proved this claim was started in the 1970s by psychiatrist Aaron Beck. He disagreed with Freud and understood that the root of suffering is in cognition and behavior, not in the “conscious versus unconscious” conflict. For example: for Beck, depression is structured thanks to cognitive patterns of self-depreciation, unreachable expectations and emotional fragility. cognitive behavioral therapy, the solution created by Beck, aims to change the structure of thought and attitudes. The psychiatrist exposed his concepts to science and was successful. His work was developed by others, more evidence emerged of the effectiveness and limits of therapy behavioral cognitive.

Beginning with Beck, scientists attest to the effectiveness of various forms of psychotherapy. For example, against borderline disorder and depression, in articles published in the New England Journal of Medicine, the most influential medical journal on the planet. Neuroscientists, some psychologists as well, have demonstrated in the journal Brain, from the University of Oxford, the efficiency of psychotherapy against internet addiction and insomnia. And they didn’t even need to write epistemology, hermeneutics, Emmanuel Kant, Augusto Comte.

Natalia and Carlos’ book invites the evidence to the debate. But I don’t know if the book is a sign that we are more concerned about science. Or, the opposite, a literary tweak to those of us who continue to run away from reason.