While medication can be helpful, it is not at all necessary to treat neuroses with medication. Freud all by himself discovered that you can completely cure neuroses through Psychoanalysis, the first form of the class of Mental Health treatment generically known as Talk Therapy.
While Freudian Psychoanalysis is incredibly effective if it works at all, it is so expensive, intensive and it takes such a long time that very few of those who undergo Freudian Psychoanalysis persist through to the cure.
What is worse is that the cure requires that one face their deepest fears. Thus even many who spend their lives on the Psychoanalysis couch prefer to stay crazy, playing the Game of Patient without ever seeking real healing.
Thus we have today more effective kinds of Talk Therapy that bring relief from symptoms without actually curing the neurosis. The most common are Cognitive Behavioral Therapy and Dialectical Behavioral Therapy.
This last was developed specifically to treat Borderline Personality Disorder, which was once known as a Garbage Diagnosis because it was widely regarded as completely untreatible. Many therapists refused even to take BPD clients on. But DBT was found to be so effective for BPD that it is now being used to treat other neuroses.
The main use for medication during Talk Therapy is to relieve the symptoms temporarily, just so the patient has the courage to deal with the real work.
Oddly, talk therapy is completely ineffective at curing the biological illnesses such as Manic Depression, Schizophrenia and my own Schizoaffective Disorder, but it is possible to recover from these illnesses completely through Talk Therapy alone, without any use of medication! Of this I am convinced. I will be taking the subject up later on in The World of Madness is Round.
It is also commonly thought that all one really requires to recover from the biological illnesses is to find the right medication, then to be compliant with the meds - that is, taking all your doses at the right times.
Ironically, while the medication can provide complete relief from the symptoms, quite often it does not provide any recovery at all. Thus we have many mentally ill who spend their whole lives living off of the government disability check, spending all their days smoking cigarrettes down at the Mental Health Drop In Centers.
There was one in downtown Truro, Nova Scotia, one of many operated all across the nation by the Canadian Mental Health Association. Recall your complaint about Mental Health Professionals who have no interest in really curing their patients.
Treatment without recovery is the mission of the Truro CMHA at least. While it is formally a part of the national organization, it is actually funded by charitable grants that they constantly have to reapply for. The Truro chapter justifies its funding largely by the number of mentally ill people who use the Drop In Center. That is, hang out all day, smoking cigarretes and eating the charity subsidized food that the members cook in the kitchen there.
While I was a regular member, I didn't spend much real time there. Sometimes I'd drop in for the cheap food, but just to socialize, and not because I was too broke to cook for myself.
They thought I was an absolute wild man, because I was flipping out damn near the entire time I was in Canada, but refused ever to hospitalize myself the whole time I was in Truro, and was endlessly passing out hardcopies of those same essays that make my fellow Kurons so weary.
Crazy yes - but refusing to play the game of CMHA Mental Patient!
I am completely convinced that my Obsessive Compulsive Personality Disorder has been cured.
But no cure is so much as speculated for either Bipolar-Type Schizoaffective Disorder or Attention Deficit Hyperactivity Disorder, both of which I have severely.
I don't really need to take medication on a daily basis anymore. I can make the symptoms completely disappear just by thinking about doing so.
I even went completely without medication for six solid years and did just fine. No mania, no psychosis of any sort. Some mild depression, but it was quite tolerable.
But I had a good reason for going back on meds and staying on them for many years: Graduate School.
While I can avoid psychosis on a routine basis through mental willpower alone, what I can't do is prevent surprises from sneaking up on me. It is for that reason that I do take my medicine regularly.
You might find the following bit comforting. I blockquote it from the Theoretical Background to The World of Madness is Round:
In the nine months since (last October) I have exhibited what many often warn me are the craziest times I have ever exhibited. Only two people ever believed me that I was experiencing not The Symptoms of Madness, but The Symptoms of Healing from Madness. The kind of healing that I have experienced has been so incredibly painful that I have been at times suicidal, many times psychotic, a few times delusional, and one time threatened - falsely, but convincingly so - violence to such an extreme that I found myself repeatedly bound in heavy leather restraints.
I have some reason to believe that this most recent event might be my last psychiatric inpatient admission for the rest of my life.
The two people who believed me were both uncommonly insightful and empathetic women. One was my therapist Dr. I., the other was an old and dear friend, one to whom I owe the world as she often sets me straight when I Wander from the Straight and Narrow.
Now, I have recovered but I have not been cured. Much like an alcoholic who has sworn off drinking forever, I will for the rest of the days be a Recovering Madman, not a Recovered Madman. There is no Twelve Step Program for folks like me, but I have a pretty good idea what I need to do to stay well.
You don't need to warn me that intentionally skipping my meds and going days on end without sleeping is playing with fire.
I'm well aware of that.
But I don't play with fire needlessly. I was informed by Dominican Intake Psychologist Joan Junquiera that in more traditional cultures, the Schizoaffectives are the Shamans.
I needed no explanation: it is because I am a Shaman that I needed no formal training of any sort both to make schizophrenics stop hallucinating, as well as to stop despondent people from taking their lives.
I joined the Suicide Prevention Service of Santa Cruz County because I wanted to put an ability I already had to good use. The intensive six-week training course only confirmed for me what I already knew. I could have taught that course before I ever took it!
Besides healing, Shamans go on Shamanistic Journeys. Typically they employ hallucinogens. The Huichol Indians of Mexico use Peyote Cactus, that they hunt with bow and arrow as if it were a deer. In the Amazon Rain Forest, they use powdered Ayahuasca root that they blow up their noses with a blowpipe employed by an assistant.
When I want to walk on alternate planes of reality, I go off my meds or go without sleep. I Don't Need Drugs To Get High, you see.
I do this on purpose, because I find that living in an intentionally altered state gives me insights into the human mind that would be otherwise unavailable to me.
Now, let me make myself perfectly clear:
I have recovered completely from my mental illness. But that is quite a different thing from being free of symptoms.
I still have severe psychiatric symptoms all the time. I just find them a useful way to live, that's all.
A while back I heard about this severely schizophrenic guy who operates a big organic farm in British Columbia. For reasons I'm not familiar with, he chooses to go without treatment of any sort, and manages to do just fine. He is self-employed, produced nutritious organic vegetables, makes a tidy profit doing right by his fellow man.
He also hallucinates on a daily basis. I understand that he commonly has giant bugs crawling all over his body.
Hope That Clears All This Up.