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"The troubling increase in treatment resistance in psychiatry has many culprits: the rise of biomedical psychiatry and corresponding sidelining of psychodynamic and psychosocial factors; the increased emphasis on treating the symptoms rather than the person; and a greater focus on the electronic medical record rather than the patient, all of which point to a breakdown in the person-centered prescriber-patient relationship. Psychodynamic Psychopharmacology illuminates a new path forward. It examines the psychological and interpersonal mechanisms of pharmacological treatment resistance, integrating research on evidence-based prescribing processes with psychodynamic insights and skills to enhance treatment outcomes for patients who are difficult to treat. The first part of the book explores the evidence base that guides how, rather than simply what, to prescribe. It describes precisely what psychodynamic psychopharmacology is and why its emphasis on combining the often-neglected psychosocial aspects of medication with biomedical considerations provides a more optimized approach to addressing treatment resistance. Part II delves into the psychodynamics that contribute to pharmacological treatment resistance, both when patients' ambivalence about their illness, the medication itself, or their prescriber manifests in nonadherence and when medications support a negative identity or are used as replacements for healthy capacities. Readers will gain basic skills for addressing the psychological and interpersonal dynamics that underpin both scenarios and will be better positioned to ameliorate interferences with the healthy use of medications. The final section of the book offers detailed technical recommendations for addressing pharmacological treatment resistance. It tackles issues that include countertransference-driven irrational prescribing; primitive dynamics, such as splitting and projective identification; and the overlap between psychopharmacological treatment resistance and the dynamics of treatment nonadherence and nonresponse in integrated and collaborative medical care settings. By putting the individual patient back at the center of the therapeutic equation, psychodynamic psychopharmacology, as outlined in this book, offers a model that moves beyond compliance and emphasizes instead the alliance between patient and prescriber. In doing so, it empowers patients to become more active contributors in their own recovery"--
This issue of Psychiatric Clinics, guest edited by Dr. Thomas Franklin, will provide a unique look into several key topics in Psychodynamic Psychiatry. Articles in this volume include, but are not limited to: Preserving the Person in contemporary psychiatry, Psychodynamic psychiatrist as advocate, The role of Personality Dynamics and Disrupted Grieving, Obstacles for Parity for Psychotherapy Benefits, Psychodynamic Theory and Treatment of PTSD, Using Transference-Focused Psychotherapy (TFP) principals in Acute Care Settings, The Overall Diagnosis, Innovative educational initiatives to train psychodynamic psychiatrists in underserved areas of the world, and Psychodynamic treatment of substance use disorders.
"This book's purpose is to promote a personalized psychodynamic therapy built on general psychodynamic knowledge and technique, free of jargon, and tailored to the needs of specific individuals. Personalized psychotherapy requires a deeper look under the hood of psychodynamic therapy; we discuss customizing techniques based on a therapeutic strategy for each individual patient that relies on an assessment of their core psychodynamic problem and strengths and weaknesses. We use over forty clinical examples of individuals in treatment in the book, with a wide variety of age, gender, race, culture and sexual preferences"--
Psychoanalysis of the Psychoses brings together a distinguished international set of contributors, offering a range of views and approaches, to explore the latest thinking in the psychoanalytic treatment of psychosis and related disorders. Drawing on findings from neuroscience, theory and clinical material from many schools of psychoanalytic thought, this book offers a comprehensive guide to understanding how psychosis is conceptualised from a psychoanalytic perspective. It looks at how to work with psychotic patients, typical problems in treating psychosis and the role of pharmacology. It demonstrates the relational dimension, capable of strengthening the patient’s observing Ego and facilitating the integration of the different areas of the personality. This process can identify and work through the main psychological stress factors involved in psychotic disturbances, transforming chaotic thoughts into springboards for important insights, and offering patients the precious chance to construct for the first time a creative relationship with their own existence. Psychoanalysis of the Psychoses will be of great interest to psychoanalysts and psychoanalytic psychotherapists as well as psychiatrists wishing to draw upon psychoanalytic ideas in their work.
Presenting a pragmatic, evidence-based approach to conducting psychodynamic therapy, this engaging guide is firmly grounded in contemporary clinical practice and research. The book reflects an openness to new influences on dynamic technique, such as cognitive-behavioral therapy and positive psychology. It offers a fresh understanding of the most common problems for which patients seek help -- depression, obsessionality, low self-esteem, fear of abandonment, panic, and trauma -- and shows how to organize and deliver effective psychodynamic interventions. Extensive case material illustrates each stage of therapy, from engagement to termination. Special topics include ways to integrate individual treatment with psychopharmacology and with couple or family work.
What if, rather than being dispensers of medication, mental health clinicians and primary care clinicians treating mental disorders were collaborators with patients in the prescribing relationship? To prescribe more effectively and to achieve health equity, Warren Kinghorn and Abraham Nussbaum argue, it's necessary--and in Prescribing Together, they offer a roadmap for making it a reality. In these pages, readers will find practical introductions to key concepts, from cultural formation and structural competency to collaborative deprescribing, and profiles, enlivened by personal anecdotes, of a diverse group of accomplished clinicians that offer evidence-based strategies for building strong alliances in the context of 13 mental disorder categories, including generalized anxiety disorder, major depressive disorder, borderline personality disorder, and neurocognitive disorders. By focusing on how, rather than what, to prescribe, this book makes room for patients' lived experiences and interpersonal and social contexts, returning to them a sense of agency and empowering them to set meaningful goals and to be active participants in their own flourishing.
Our remedies are only as good as the way in which we dispense them. That is the central premise of Thinking About Prescribing. In this new, thought-provoking volume, more than two dozen experts make the case for an ongoing alliance between pharmacotherapists, young patients, and their families. Chapters tackle issues ranging from the psychodynamics of medication use in youth with serious mental illness, adapting evidence-based motivation and therapy techniques to enhance adherence, cultivating the synergistic role of primary care providers and psychotherapists, engaging in psychoeducation with patients, to prescribing via telemedicine. Readers will pick up the foundational knowledge they need to develop a partnership with patients that is based on trust and candid communication--rather than on just the cold facts about psychotropic medications. Chapters feature key takeaways that distill the most salient points, helping readers to reference--and retain--the information easily.