Psychodynamic Psychiatry最新文献

Introduction: Process notes contain unique information concerning core elements of a psychodynamic treatment. These elements may be both conscious and unconscious for the author. One element for study is the tendency to which a therapist writes about providing either supportive or expressive interventions. This study sought to establish a method of systematically and reliably identifying the records of therapists' interventions as supportive or expressive. Methods: Three early-career clinicians were trained in the use of a process note intervention rating scale constructed specifically for this study. Quantitative statistical analyses assessed the scale's reliability and internal consistency. Results: Interrater reliability analysis determined at a p of 0.005 a Fleiss's kappa of 0.24 and an intraclass correlation coefficient of 0.264, suggesting a low but statistically significant reliability between the raters. A Cronbach's alpha of 0.67 and a McDonald's omega of 0.53 suggested questionable internal consistency. Discussion: Early-career clinicians can reliably code the manifestations of interventions in psychodynamic process notes as supportive or expressive. Future studies may improve the reliability and internal consistency of the scale, add measures of interpretation content, and evaluate these data in relation to other core elements of process notes, such as the author's emotional engagement as manifested in language measures and clinical outcome.

The development of psychoanalysis and psychodynamic psychiatry in China is influenced by political, economic, cultural, and social ideology. The process of psychoanalysis entering China is also a reflection of Chinese history, mirroring China's transition from conservatism to openness, from focusing on tradition to embracing modernity, and from focusing on community and family to individualism. These changes align with the Chinese continuous exploration and pursuit of integration, adaptation, and individuation in the process of globalization, urbanization, and modernization. This article describes the continuous expansion and development of psychoanalysis and psychodynamics in China parallel to societal changes and how an increasing number of people have begun to engage in psychoanalysis or psychoanalytic practices and research. The author describes challenges to how psychoanalysis can better serve the Chinese people through clinical practice and in-depth research under the country's unique social, cultural, historical, and political background.

The transformative therapeutic relationship is a unique interpersonal and intrapsychic phenomenon between analyst and patient. It occurs within the therapeutic framework, and is characterized by specific boundaries of time, place, and verbal and behavioral interactions. Collectively, these interactions may facilitate mutual trust, caring, respect, and affection between analyst and patient. The shared experience of the transformative therapeutic relationship can result in significant intrapsychic and interpersonal changes for both patient and analyst. Clinical case presentations are provided.

Interpersonal psychotherapy (IPT) is an empirically validated treatment for mood disorders, anxiety disorders, eating disorders, and trauma. IPT is based on the concept of "relational frame"-that an individual's experience of psychological distress impacts those around them, and that their social support network impacts the distressed individual. This concept, along with the specific techniques and tools that flow from it and the theoretical bases of IPT (attachment and interpersonal theory) make IPT unique. In this article we review the theoretical bases of IPT (attachment and communication) and provide a brief history of IPT, as well as the evidence supporting its use for a variety of disorders. We also describe its application to groups, adolescents, and other diverse populations. Future directions for research and treatment development are proposed, particularly research in the area of combining IPT with other psychotherapeutic modalities.

There is an ongoing tension in the psychodynamic field between interpreting the meaning of a patient's verbal productions or actions and addressing the defenses utilized by the patient. Some authors maintain that implicit interactions between analyst and patient may be more important than the verbal interventions by the analyst. This article stresses the importance of observing and appropriately addressing how patients manage painful affects in the sessions. Focusing the patients' attention on their at-the-moment defenses as they occur in the session is an experience-near intervention and minimizes interventions that address issues far from the patient's consciousness and that require a high level of conjecture by the therapist. This technique can be utilized at any point in treatment, regardless of its duration and intensity. Several vignettes are provided that suggest that addressing defenses against painful affect is a pantheoretical construct and may be a common factor in psychodynamic treatment. A successful randomized control trial utilizing this technique with children (regulation-focused psychotherapy) is described. There have been limited empirical studies of the impact of therapists addressing defenses in sessions, but the work of J. Christopher Perry and colleagues, particularly the development of the Psychodynamic Intervention Rating Scales, offers an opportunity to further study the impact of defense interpretations and other interventions.

Borderline personality disorder is a common, treatable condition that usually presents in late adolescence or early adulthood. Patients with borderline personality disorder are disproportionately represented in many clinical settings. Early identification and intervention of borderline personality disorder could help address the current mental health affecting young adults. College and university mental health settings have an opportunity to identify borderline personality disorder and to help guide students and families to appropriate treatment. College-based clinicians also have a role in educating campus administrators who may have little or no familiarity with standard borderline personality disorder symptoms or the trajectory of the disorder.

Since he first proposed it, Carl Jung's "archetype" theory has faced resistance from a pervasive but seldom examined set of underlying Cartesian assumptions embedded in mainstream psychology. This paradigm assumed a physical universe (and hence body) free of psyche that coincided with an essentially disembodied mind largely concerned with abstract symbol manipulation. This situation led archetype theory to remain largely within insulated psychoanalytic circles for decades. Since the 1980s, however, cognitive psychology has increasingly become embodied from a variety of standpoints. This article shows how the results of embodied cognition and spontaneous thought "demystify" many of the attributes Jung described in his archetype theory, making archetype theory not only more comprehensible but clinically applicable. Combining approaches suggests new avenues of inquiry for experimental research and enriches the psychoanalytic perspective.

This article delves into fundamental themes within Margaret Mahler's separation-individuation theory, placing particular emphasis on the rapprochement phase. It illustrates how these themes are crucial for comprehending and effectively managing inpatients grappling with borderline personality disorder. Mahler's conceptual framework offers valuable insights for caregivers and staff, equipping them to navigate the clinical and emotional complexities inherent in the treatment of this distinct patient population during their stay in psychiatric wards.

This article explores the intricate relationship between smartphone usage and mental health and the unintended consequences of the rapid integration of this technology into daily life. It explores the ways in which smartphones disrupt opportunities for introspection and self-reflection, decrease engagement in external reality, increase engagement with realities of the virtual world, precipitate ego destabilization, and interfere with sleep and dreaming. The author explores ways in which the split between the real self and the ideal self is impacted by social media. The influence of smartphones on mental health is a complex and evolving issue, demanding ongoing research, understanding, and a heightened awareness of the potentially deleterious consequences of overusing technology in our ever-changing world.

Erik Goodwyn in this issue ("Demystifying Jung's 'Archetypes' with Embodied Cognition") argues for a reexamination of the clinical and neuropsychological relevance of Jungian archetypes. This assertion is examined with respect to the evidence Goodwyn provides as well as in the larger context of cognitive science as it is applied to theories rooted in past models of cognition.