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Quote by Matshona Dhliwayo

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Matshona Dhliwayo

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“For people who are depressed, and especially for those who do not receive enough benefit from medication of for whom the side effects of antidepressants are troubling, the fact that placebos can duplicate much of the effects of antidepressants should be taken as good news. It means that there are other ways of alleviating depression. As we have seen, treatments like psychotherapy and physical exercise are at least as effective as antidepressant drugs and more effective than placebos. In particular, CBT has been shown to lower the risk of relapsing into depression for years after treatment has ended, making it particularly cost effective.”

“However one may interpret this culturally, the upshot is the same: people carry within them a great number of wishes to which they react passively and which they hide. Stoicism, in our day, is not strength to overcome wishes, but to hide them. To a patient who, let us say, is interminably rationalizing and justifying this and that, balancing one thing against another as though life were a tremendous market place where all the business is done on paper and tickertape and there are never any goods, I sometimes have the inclination in psychotherapy to shout out, “Don't you ever want anything?” But I don't cry out, for it is not difficult to see that on some level the patient does want a good deal; the trouble is he has formulated and reformulated it, until it is the “rattling of dry bones,” as Eliot puts it. Tendencies have become endemic in our culture for our denial of wishes to be rationalized and accepted with the belief that this denial of the wish will result in its being fulfilled. And whether the reader would disagree with me on this or that detail, our psychological problem is the same: it is necessary for us to help the patient achieve some emotional viability and honesty by bringing out his wishes and his capacity to wish. This is not the end of therapy but it is an essential starting point.”

“ME/CFS has been classified as a neurological disease by the WHO since 1969 [59] and a growing number of researchers theorize that ME/CFS might be a neuro-immunological condition [60–63]: yet the BPS framework does not account for ME/CFS as a neurological or immunological disease – instead, much of the pro- BPS model literature on ME/CFS adopts what Nassir Ghaemi terms the ‘eclectic approach’; whereby everything appears important, all bio, all psycho, and all social factors [33]. Yet in clinical practice (the BPS framework), there is strong emphasis on psychological interventions (CBT and GET).”

“A useful first step is to reverse engineer the situation back to the triggering event and to define the specific problem you are facing. You can then determine options for handling it. The various manifestations of anger reflect a sense that something is “not fair,” which is related to a should statement, such as “this should not happen.” Dealing with “shoulds” involves acknowledging that you obviously are not happy that something happened, but that you must still face the fact that it did happen. Thus, the task then turns to dealing with the situation.”

“What about the claim, by the PACE trial, that Graded Exercise Therapy and CBT can treat ME? This is a trial where you could enter moderately ill, get worse in the trial, and be declared ‘recovered’ at the end. Even the recent follow-up study conceded that, long-term, Graded Exercise and CBT are no better for ME than doing nothing. Investigative journalists and academics alike have dismissed the PACE trial as ‘clinical trial amateurism’. Like MS or epilepsy, which were also once wrongly believed to be psychiatric disorders, ME is a neurological disease, and the World Health Organisation lists it as such. I am too weak to walk more than a few metres, needing to lie in bed 21 hours a day. With the little energy I have, I am an ME patient activist.”