Psychodynamic Psychiatry最新文献

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.

In the 1970s Massimo Fagioli (1931-2017) proposed a new theory of mind that he called the Human Birth Theory, based on a healthy conception of the baby and of the nonconscious mind. Fagioli made significant contributions to the understanding of mental dynamics at birth, the pathophysiology of mental illness, and the nonconscious identity of psychiatrists and psychotherapists. His original contributions to psychodynamic psychotherapy included variations on the setting and understanding of transference and dream interpretations that deviated from classical psychoanalytic techniques. This article introduces the basic tenets of Human Birth Theory, its neuropsychiatric correlates, and clinical applications.

This article explores the problems of the frequent loss, in the course of treatment, of the initial goals and motivation for treatment by both patient and therapist, and the connected lack of clarity of the real initial motivation for treatment on the part of both participants. It is strongly proposed that a true coincidence of at least one important initial motivational goal of patient and therapist is essential to assure the success of psychotherapy and that particular care is required to establish such agreement. On this basis, the goals of therapy may be expanded in the course of the therapist's experience, countertransference, and the patient's changing reality during treatment, and the existential and philosophical value systems of the therapist may play an important role in such widening of the therapist's expectations for the patient.

Patients with primary or co-occurring narcissistic disorders are seen routinely in general psychiatry settings. Contemporary trends in training and practice have impacted psychiatrists' skills and confidence in identifying and treating these disorders, which can range from relatively benign to high-acuity presentations. The goal of this article is to introduce key principles derived from transference-focused psychotherapy (TFP) for use by clinicians in general practice in their work with patients with narcissistic disorders, even when those clinicians do not routinely provide individual psychotherapy. Practical application of TFP principles in work with patients with narcissistic disorders in general psychiatry are proposed, including in diagnostic evaluation, family engagement, prescribing, and safety assessment and risk management calculus. Many psychiatrists whose practices are focused primarily on psychopharmacology, or a "medical model," may not appreciate fully the impact of pathological narcissism in their work. Clinicians who may benefit from familiarity with TFP principles in work with patients with narcissistic disorders include the approximately one-half of U.S. psychiatrists who do not offer psychotherapy in their practice.

Conversion disorder-called functional neurological symptom disorder in the DSM-5-has roots that trace back to antiquity. The term conversion, originating from psychoanalysis, signifies the appearance of physical symptoms as an effort to resolve or convey unconscious and distressing intrapsychic conflicts- "converting" them from manifesting in the mind to manifesting in the body. Despite efforts made in elucidating the neurobiological etiologies of functional neurological symptom disorder, a psychodynamic lens remains indispensable in understanding the patient. This article presents two patients who developed functional neurological symptom disorder, one after a COVID-19 vaccination and one in the context of long COVID. A discussion follows on the intrapersonal, interpersonal, and systemic etiological factors that predispose, precipitate, and perpetuate COVID-related functional neurological symptom disorder. We elaborate on psychodynamic psychological processes and conflicts that may unfold between patients with COVID-related functional neurological symptom disorder and their health care providers. We also share suggestions on how a consultation-liaison psychiatry team may offer support to the primary treating team to facilitate a therapeutic space within which patients with COVID-related functional neurological symptom disorder may recover.