Reflections on Psychiatry & Psychology

Study of 252 cocaine-dependent patients tested whether early therapeutic alliance predicts drug-treatment outcomes across several therapies. Alliance weakly predicted outcomes (better for depression than drug use). Design issues—many variables and mixed treatments—may have limited conclusions.

Carla, 48, battled anxiety and panic since 16, relying on long-term meds without therapy. Ketamine-assisted psychotherapy helped her confront childhood trauma, easing rigid thinking and accelerating recovery.

Hypervigilance to bodily sensations can trigger faster breathing and hyperventilation, lowering CO₂ and reducing oxygen delivery to tissues. This causes dizziness, tingling, and panic. Alcohol may give brief relief but worsens anxiety later; therapy can help.