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A Psychotherapist on 'The Effect'

posted: 4 months ago

The Effect 2

I had not anticipated to commence my review of this play about psychotropic drugs with these words, after all, the production was lauded unanimously everywhere. But this is an infuriating play!

The broadsheets were celebrating the courage of tackling the billion-dollar industry that is at the centre of the play, and were amazed by Billie Pipers acing ability. Of course, the not-so-highbrow reviews concentrated more on the sexual exploration that runs along the drug theme, and again all the actors came in for great praise.

But coming into this play, I can't help but think about the fact our values reflect the changing times. Shyness, once prized as thoughtfulness, nowadays can be classified as a social phobia in hands keen to ‘heal’. Melancholia or sadness, once recognized as part of understanding the fullness of life, is now all too easily described as depression (and here, have some drugs to make it disappear).

The side effects of all those drugs are well hidden from the public eye, until tragedy forces companies like Elie Wiesel to admit to them. But who remembers the cases of killer veterans – all on the same drug – after a few years? Who remembers the Kirsch meta-study proving that the newest drugs against depression like SSRIs are less powerful than CBT, Meditation or other modern psychotherapies in moderate depression cases? Nobody doubts that some drugs have a serious role to play for very serious disturbances, even though the role that interpersonal contact plays even then is not appreciated as it is rarely measured.

I was very keen to see how a modern writer would tackle this. And initially, all seems well – the trial of an anti-depressant presented seemed well considered. Our protagonists, a psychology student keen to experience this research as a personal experiment and her new friend made sense. These characters were believable.

They were contrasted well with two doctors, psychiatrists of very different persuasions. Again, this seemed dramatically clever and also fair to psychiatry, after all, not all psychiatrists are keen drug sellers, even though they both are working in the trial.

As the drama unfolds, we are confronted with more than medical questions. We are compelled to ask ourselves important, essential questions about the nature of love. Is it really just a chemical reaction? Or is it environmental? Do people 'fall' in love in the right settings, like at a conference of like-minded professionals, as here?

Or do we 'make' love? Are humans actually able to create love? A beautiful, sensual scene shows us how tender love can be; I have rarely seen loving sex so well portrayed on stage, so truthfully. And to see the girl take care of her injured lover made my heart expand with pride for our human capacities!

Equally, the staging is very creative; we are very much a part of this play literally – some of us actually sit in the set.

And yet. Why, did I leave the theatre fuming with anger? Because sadly the writer has succumbed to her own dilemma. Yes, overprescribing of anti-depressants is wrong. Yes, these pills have side effects most people gravely underestimate. Yes, we as a society have to reset our values soon, or Soma-land beckons and Huxley was right after all.

But to stop there is highly irresponsible. There will be people going to this play because they are depressed, and I am infuriated they have been let down by by ideas put forth for dramatic effect. Too often these days we delude ourselves with neuroscience into thinking that we are in control of our emotions, our thinking, our life.

There are well known and well researched methods against depression. Jon Kabat-Zinn’s integrative, 'Mindful' approach has been effective for 30 years. Modern psychotherapy (not psychoanalysis!) incorporating this and either Cognitive Behavioural Therapy or another thought-educating approache also work well. Central to all these is self-efficacy training, offered within a highly personal therapeutic relationship – two humans looking for a way together to make life joyful again.

The answer is definitely not: "All we can do is keep breathing," as the last line of the play suggests.

Click here to read A Layman on 'The Effect'.

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