Talk therapy puts medication on the shelf

Thomas Szasz once noted that, “Psychotherapy is a confidential conversation that has nothing to do with illness or medicine, but is a relational dialogue, distinct from the medical framing of illnesses and pharmacological treatment.”

As a society, we have become deeply dependent on medication to resolve stress or distress of almost any kind. Too often, this comes at the expense of addressing the root causes through less toxic, more transformative approaches such as talk therapy, including counselling and psychotherapy.

Psychosocial interventions provide deeper support, offering space for long-buried issues to surface and be addressed. Yet the question remains: why has society developed such a strong dependency on medication?

Modern psychiatric practice is rooted in the biomedical model, which frames mental illness as a chemical imbalance or brain dysfunction. Consequently, treatment is often reduced to pharmacological solutions such as antidepressants, antipsychotics, and mood stabilisers. These are frequently prescribed without a more thorough exploration of the psychological, social, or environmental influences shaping a patient’s distress.

Researcher Irving Kirsch, a leading authority on placebo effects and psychotherapy, has argued that psychotherapy works, and some types of therapy have been shown to be much more effective than antidepressants over the long run.

We live in a “quick-fix” culture. Medications can provide rapid relief from symptoms, allowing individuals to continue to function in a productivity-driven world. However, this relief is often temporary, acting as a Band-Aid that may mask deeper issues. When therapy is eventually sought, the presenting problems may have multiplied, with addiction or other behavioural challenges compounding the original difficulty.

Talk and creative therapies, by contrast, require more time and commitment. Clients who engage fully in these processes can achieve lasting results. In my own experience, such therapies lead to significant changes in cognition, physiology, and lifestyle, creating foundations for sustainable recovery.

Unfortunately, in many countries, mental health services are underfunded, leaving countless people with little choice but to seek “quick fixes”. This highlights the urgent need for greater investment in counselling centres and supportive therapeutic programmes.

The pharmaceutical industry has also played a decisive role in shaping mental health treatment.

Its influence, reinforced by a medical culture oriented toward medication, has led to the widespread prescription of drugs that may not always be necessary. Marketing campaigns often reinforce the notion that medication is the solution to all emotional distress.

In contrast, talk therapy looks beyond symptoms to address their underlying causes. Through psychotherapy, patients can uncover early traumatic experiences, learned behaviours, or inner conflicts. Instead of believing that they will require medication for life, patients can be empowered with emotional-regulation strategies and long-term coping tools. Unlike medication, therapy doesn’t dull awareness; rather, it enhances self-understanding, offering insight, healing, and renewed purpose. This isn’t to suggest that medication has no role. For severe conditions such as bipolar disorder, schizophrenia, or manic depression, pharmacological treatment can stabilise patients and make therapeutic engagement more effective. The most balanced approach may involve combining medication for symptom relief with talk therapy for deeper healing, equipping patients to manage their lives with greater resilience and autonomy.

• Shalom Lindhorst-Grays is a qualified counselling psychotherapist who has been working with people in South Africa over the past 10 years and with clients that have been victims of abuse, rape, gun shots, or hijacking.