Psychodynamic Psychiatry最新文献

Dr. Mark Solms recently completed a 30-year update of the definitive English-language version of the complete works of Sigmund Freud. This new 24-volume set, referred to as the Revised Standard Edition of the Complete Psychological Works of Sigmund Freud (RSE), was published in the spring of 2024. In this interview, Dr. Solms discusses Freud's scientific works and correspondences that were either newly discovered or newly translated (by him) into English and added to this new edition. Included in this discussion are writings that, Solms believes, have the potential to change the way Freud is viewed within his cultural epoch. Also discussed are the ways that Freud's religious background may have shaped his theories.

While the roots of school violence are complex and multidetermined, the origins remain deeply embedded in our society. It is now established that there is a high prevalence of mass shooters with undiagnosed and untreated psychiatric illness. In this article case material illustrates the psychodynamic and psychosocial determinants of school shootings. Shooters typically experience loss, trauma, bullying, abandonment, and undiagnosed psychiatric illness. They are often unwanted and marginalized children living in abusive environments. This article describes the psychodynamic relevance of the concept of soul murder and emphasizes the extreme isolation and loneliness experienced by shooters. The cases described might have been prevented had the assailant, after typically being identified as "troubled" by secondary support systems, such as families, schools, and law enforcement officials, received appropriate psychiatric treatment. There is an urgent need for more of an interdisciplinary approach involving families, school counselors, law enforcement, mental health workers, and lawyers, with a redoubling of efforts to secure appropriate psychiatric treatment for children with mental illnesses who are marginalized and may have a higher risk of violence than the general population.

This introduction to the special issue on mentalization-based treatment (MBT) with children, adolescents, and families highlights a range of conceptual and clinical contributions that illustrate the richness and usefulness of applying developmental and family systems perspectives to an MBT framework to alleviate the plight of young people and their parents.

This article reviews an approach to working with families that grounds in systemic thinking the framework of mentalization-based treatment. Employing a mentalizing stance, this approach aims to interrupt coercive, nonmentalizing cycles of interaction within the family system and replace them with mentalizing conversations in which epistemic trust and the shared social-emotional learning of the we-mode can be generated. The process thus promoted is a spiral of shared attention and co-mentalizing, constantly lost and then recovered, in which therapist and family members learn to hear, recognize, understand, and trust one another and repair the inevitable disruptions in mentalizing and trust that allow family members to experience a way of shared knowing- the we-mode-that they can apply to communicate and solve problems both within the family system and in the broader social systems in which the family is embedded.

Epistemic trust-trust in the relevance and utility of social learning-is central to helping processes between clients and workers in helping services. Yet, due to their experiences, clients may adaptively develop predispositions toward stances of epistemic mistrust or epistemic credulity. From an AMBIT (adaptive mentalization-based integrative treatment) perspective, this article argues that epistemic mistrust and credulity are both caused by social injustice and generate further social injustice. Helping services commonly respond in ways that fail to acknowledge this social injustice and, perversely, deliver further injustice still. Our primary focus is how these issues relate to work with clients, but we argue that they are present in work within AMBIT's other foci, too: in teams, multiagency networks, and learning. We conclude that workers and helping services have a moral duty to recognize and attend to the multiple social injustices associated with epistemic mistrust and credulity.

In this article we describe the structure and technique of mentalization-based therapy for adolescents (MBT-A), an evidence-based intervention that has shown effectiveness in helping young people with self-harm, borderline personality, and depression. We describe also the differences between MBT with adults and MBT-A, which primarily focuses on the developmental aspects of adolescence. The developmental trajectory of adolescence culminates in a coherent and consolidated sense of self. Mentalizing provides the main supporting socio-cognitive-emotional process for achieving a coherent sense of self and, consequently, authentic and rewarding intimacy, making its evolutionary relevance clear and underscoring the importance of scaffolding this critical process during adolescence, regardless of diagnosis or therapeutic modality. We further argue that mentalization is a central mechanism by which personality functioning is achieved. In our view, mentalizing can be seen as a cross-diagnostic feature common to all personality pathology and, arguably, all psychopathology. This broadens the relevance of MBT-A beyond its original remit of self-harm and borderline personality disorder and identifies the enhancement of mentalizing and epistemic trust as a common factor in all psychotherapies that support adolescents through a challenging but critical developmental period. As such, mentalizing can be viewed as the property of all good psychotherapy.

This article presents a mentalization-based treatment (MBT) framework for working with parents that fosters the emergence of mentalization in a context grounded in relational and developmental points of view. A basic premise of this framework is that mentalization and epistemic trust provide protective factors for parents during moments of family stress, promoting the parents' capacity to negotiate the developmental tasks of parenting, as these tasks interact with both their inner world and the external realities of an ethnically and racially diverse, gendered culture.