Complementary And Alternative Medicine In The Treatment Of Personality Disorders

I just recently had the chance to speak to Dr. Philip Muskin, a renowned psychiatrist and head of Consultation-Liaison Services at Columbia University Medical Center. Dr. Muskin, together with colleagues Drs. Richard Brown and Patricia Gerbag, just published a book on using complementary and alternative medicine in mental health care. 

The book covers the use of different herbs, Yoga, breathing techniques, and nutrients for a vast array of mental health issues, for example, Depression, Anxiety, Memory Difficulties, and Substance Abuse. In addition, these methods can be really helpful for people who are experiencing side effect from medications. What’s really impressive about the book is the amount research literature the authors have reviewed, together with the way by which they integrate these research finding with their ample clinical experiences, and the useful vignettes they offer.

Personality Disorders per se are not covered in the book, however, some difficulties that people with Personality Disorders often experience, such as symptoms of depression, stress, or anxiety are addressed in considerable depth.  So, is there room for using complementary and alternative methods in the treatment of people with Personality Disorders?

“Currently, there is no one established pharmacological treatment for Personality Disorders”, says Dr. Muskin, “We use antipsychotic and antidepressant medication to help with components of the symptoms. One of the main issues with Personality Disorders is stress, and complementary and alternative medicine do have a lot to offer in that regard. Breathing techniques and mindfulness practices are very effective.  The point is to show people different ways of dealing with things, and to get them to accept the stress of what it means to be them. ”

The book covers extensive information on anxiety and the stress response system, and introduces a number of different mind-body practices that can be helpful, from different breathing techniques, to Quigong, Yoga, and mindfulness meditation.

 “More and more frequently, I teach my patients breathing techniques. It really does not matter all that much which specific breathing technique it is, though I like the one by Stephen Elliot,” says Dr. Muskin.  Stephen Elliot developed a technique called coherent breathing , which is a modern adaptation of a technique that practices taking approximately five breaths a minute.  “Teaching breathing techniques is not treatment. It is maintenance to keep stress levels at a manageable level.  You use it the same way as brushing your teeth.  They’re not designed to treat people, but keep them well.“ Another technique that, according to Dr. Muskin is very effective for anxiety, is Yoga.  “Yoga is probably the best thing for anxiety. People really benefit from it, and you don’t have to be good at. However, you really need to practice it. ”

Do complementary and alternative medicine offer a magic bullet to help people with Personality Disorders?  According to Dr. Muskin, none of these things do any miracles, but they are useful. “All this stuff is useful”, says Dr. Muskin, “but not for everybody.  Often, people practice these techniques for a while and then they suddenly stop, and they often don’t know why they stop. It takes a lot of practice. Otherwise, the rapid effect is just not there.”