Does Anxiety Obstruct or Motivate Treatment? When to Talk, When to Prescribe, and When to Do Both

With increasing frequency clinicians are using a combination of medication and psychotherapy as the preferred treatment strategy for a wide range of patients. Consequently, analysts and therapists are often referring patients for psychopharmacological consultations-sometimes in the hope that medication will lessen the intensity of depressive or anxiety symptoms, thereby facilitating the induction of psychotherapy, or sometimes with a wish that medication will unblock a stalemated treatment. Transcending the unique circumstances of each consultation are those beliefs held by analysts that underlie a sometimes subtle and sometimes overt adversarial relationship to medication. Indeed though medication and psychotherapy are often combined, giving two types of treatment simultaneously does not mean that the modalities have been either practically or theoretically integrated. In fact, combined treatment, though often effective, can be a treatment in conflict.