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The Serotonin Surprise

"I think you have to accept that there's a structural change in your brain when you take drugs like Prozac."

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Psychotherapists love to argue. We argue about treatment theories, about our clients and their families, about the office coffeepot. And during the past decade we have tended to fixate, as we say in the business, on the subject of Prozac. It used to be fairly easy to agree about commonly prescribed psychiatric drugs such as Valium: They anesthetized people, covered up problems, illegitimately took the place of therapy. But Prozac and the other antidepressants that work by enhancing serotonin activity in the brain have eluded such easy criticism. Often we would find that our clients who took them felt more alive, more resilient, more able to engage in the honest self-reflection necessary to therapy. And we could not help but agree with Peter Kramer, who wrote in Listening to Prozac that the drug can remake the self— which was supposed to be our job.

Therapists haven't been alone in their ...

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