What is 'Drugless Psychiatry' or Subjective Emotive Brief Therapy?
The procedure of therapy is simple.
A detailed history is taken first. A relaxation exercise is
given for homework-to be done from three to thirty minutes daily. In each
session of therapy, relevant unresolved issues are addressed using imagery and
associated emotions. As the person becomes calmer with therapy and
relaxation exercises, the mind is challenged more intensely with each
successive session. The previously unresolved issues become
"irrelevant" as treatment proceeds. A common word used by
clients is -"Realization". They tend to have more insight and
"forgiveness" follows spontaneously. Traumatic memories
become more vivid initially and then become hazy as therapy proceeds. So
everything traumatic in memory is capable of being neutralized.
Eventually lessons are left from the experiences that were
previously distressing with emotions dissipated.
As an issue is addressed a client may experience restlessness, anger and
sadness in succession. A stage of numbness can sometimes precede sadness.
As the body releases tension, the client may go into a prolonged phase of
extreme tiredness that may last for upto two weeks. By this time the mind
has released most of the 'misery creating' issues and becomes alert,
interested in daily living but lacking the energy to enjoy daily activities.
This is the penultimate phase in recovery. The end point in this work is
always positive. If someone has not experienced positivity while
engaging in Subjective Emotive Brief Therapy, they have not reached the end
After a person has concluded treatment, they are advised to continue some
form of relaxation or meditation for as long as possible.
How can psychiatry be drugless?
Psychiatry is a specialty of medicine in which a doctor makes a diagnosis after
taking relevant history and examination. Treatment is done mainly
with drugs with psychotherapy having a limited input. In Chadha Model
Subjective Emotive Brief Therapy, psychotherapy can become the major mode of
treatment with medication playing a secondary role.
How can it be practised?
The sufferer in a psychiatric condition is an expert on their
own distress state. Anyone who is not in the place of the sufferer
cannot imagine the depth of distress a person could be experiencing.A
psychiatrist can be an expert in mental illnesses but they only have an
objective view of the condition.In Subjective Emotive Therapy,the
subjective distress is 'utilised' ( as Milton Erickson would put it) for
treatment. The emotional distress related to each unresolved issue that the
person can have access to, is neutralized or desensitized. It is
an intense process. A person not on medication who has good social
support and does not have major personality problems can finish treatment quickly as compared to others. Since 1996, hundreds of people have benefited from this
work.Confidentiality issues do not permit disclosure of such cases.
What is the theoretical basis of Chadha Model Subjective Emotive Brief
Almost all psychiatric conditions can be understood on the basis of
neurochemical imbalance in the body. Trauma and stressful situations can
trigger such conditions. Since these imbalances are caused naturally,then
reversing the distress by relaxation, meditation, hypnosis and acupressure can
recreate the balance in the neurochemicals in the body. This is possible by
'burning out ' the emotional impact of distressing memories and images. This is done by using relaxation as the foundation of therapy, which has to be done regularly combined with imagery exercises that are done under supervision. As the person becomes more relaxed they find it successively easier to dissipate the emotional distress with imagery. As the bottled up emotional distress is dissipated, the person becomes more relaxed. This is carried on till the person is comfortable with their emotional, physical and mental health.
What is the role of medication in this form of therapy?
Medication suppresses the emotional arousal
state by interfering (not replacing) the neurotransmitters in the nervous
system. This may become necessary when the person's condition is a
threat to themselves or to others or when the quality of life is rapidly deteriorating.This happens when a person loses
insight.In such conditions, medication is a support to the psycho-therapeutic
process.Reducing medication can be considered by
the prescribing physician only if the patient is stable.Any reduction
in medication results in emotional arousal, which can be mostly,
neutralized with therapy. This can be done successively till the person is
off drugs.Medication suppresses emotions, relaxation releases them. If a
patient can tolerate the current stresses in life without affecting others,
they are most suitable for Subjective Emotive Brief Therapy.
Do emotions play a role in mental health conditions?
Most of the functional psychiatric conditions follow stressful life events.
Emotions play an important role in the physiological experiences of these
events. We now know that neuropeptides are the chemical forms of memory
in the body stored not only in brain cells. Counselling and psychotherapy reduce
the impact of negative emotions -like anger or fear- on mental health.Chadha
Model Subjective Emotive Brief Therapy works at a deeper level and is far more
intense than counselling.
What is the role of stress in health?
The role of stress in the causation of psychosomatic and mental health
conditions is now well known. Any organ in our body can be affected by
stress.There are internal stressors locked up in the body's memory from past
experiences that we are unaware of. These are in the form of
neuropeptides.When adverse environmental situations present themselves,the
internal stressors are activated and we experience stress in our awareness. It
affects our immune system among others. We get illnesses and infections
that occur due to our body's healing processes being challenged.Now
scientists are looking at stress as being one of the causes of cancer.
Psychologically stress is experienced as anger, irritability, panic and
phobias.Lethargy , sadness and depression may follow. It has
economic, family, social and personal consequences.It also affects our
creativity and decision-making ability.
What kind of patients do not respond to this treatment?
People who depend on others to change them are unsuccessful in this kind of
treatment. Those impatient to get results and those who hold everyone
else but themselves responsible for their suffering. People who are
fearful of change are initially less likely to do well. People who have
no family or social support are least likely to do well.Those who analyze
everything and who think too much are slow in benefiting from this
treatment. Acutely psychotic patients, including those suffering with
some forms of schizophrenia & organic disorders are also sometimes less likely to
What is to be expected in this form of treatment?
A person undergoing treatment may go through the stages of agitation, anger ,
sadness and resolution successively,as each distressing issue is addressed.The
final outcome is always positive. The paradox is that the more acutely
the results are expected, the slower is the process of change.People who
benefit most are those who are patient with themselves. The process
brings positive results, when completed.Yet there are no guarantees that
everyone who takes on therapy will complete the process.