Pre-oedipal phenomena, affect disorders, and biological psychiatry.

With the emergence of biological psychiatry as a major political, conceptual, and treatment force, the diagnosis of endogenous depression is being applied across a broad range of clinical conditions. In such a climate, controversy surrounding the diagnostic enterprise, the somatic treatment of affect disorders, and the conceptualization of psychopathology poses important and exciting challenges to psychoanalytic psychologists practicing in medical settings. These issues are examined through a clinical illustration involving an 18-year-old adolescent girl diagnosed and treated as a "major affect disorder." Her Rorschach protocol is highlighted with a view toward describing and coming to understand the patient's experience of depression, significant others, and herself. The role of psychoanalytic object relations theory, developmental psychoanalysis, and self-psychology in providing a phenomenologically based, "experience near," unified view of the whole person is advanced as one possible corrective measure for slowing down and critically evaluating the movement toward an exclusively biological view of psychopathology and treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Joint report on relations between psychology and psychiatry.

"The members of both committees felt it essential to reestablish more effective communication… . The public need is such and the professional manpower problem is such that both parent groups cannot fail to recognize the legitimate interests of society as a third part in their negotiations and in their interprofessional relations." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy and chaos theory: The metaphoric relationship between psychodynamic therapy and chaos theory.

Explored potential benefits and problems in applying chaos theory in psychotherapy through an examination of previous attempts to integrate chaos theory in psychoanalysis and psychodynamic therapy. First, a discussion provides an understanding of basic concepts in chaos theory and reviews applications in psychoanalysis. Second, problems in such application are scrutinized. Finally, the discussion speculates on a general tendency in the literature in psychotherapy and counseling to resort to mathematical analogies, arguing that this attraction may produce an "erroneous metaphor," and gives reasons both for the attraction and its danger. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships between psychology and psychiatry: the hidden issues.

The "… underlying bases of friction between professions of psychology and psychiatry" are explored. Friction emanating from psychiatry stems from the medical pretense of omniscience, an elevated regard for the M.D. degree, and the psychiatrist's position as "… low man on the medical totem pole." Activities of psychologists entering private practice represent "… an economic threat to psychiatrists." The "psychiatrist's theoretical dogmatism… can be attributed to lack of training and sophistication in the content and methods of psychology." Friction emanating from psychology stems from a claim to omniscience, an elevated regard for the degree in psychology, and psychologists trained in areas other than clinical becoming clinical psychologists "… by fiat alone… ." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training in psychodynamic therapy.

Psychotherapy training began early in the history of psychoanalysis, and its methods (didactic training, supervised case work, and personal analysis) have remained essentially unchanged. The psychoanalytic literature on training consists largely of case studies and theoretical papers, with empirical work being quite limited. This article critically reviews the empirical literature relevant to each component of the training process, including the selection of candidates, personal therapy, didactic course work, and supervised experience. Particular emphasis is given to the problem of establishing a research criterion of therapist competence as a necessary step toward investigating training. Recent advances in the definition and measurement of competence (adherence, skill, and personal involvement) are reviewed. Future directions are discussed, along with a recommendation for integrating research findings and methods into ongoing training programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between primary care and psychiatry: an opportunity for change

The past two decades have seen the development of a symbiotic relationship between primary care and psychiatric services. The changes which have taken place, however, have been piecemeal and variable in their extent. With some exceptions, they have followed an empirical route, and have come about largely because individual practitioners intuitively felt that they yielded positive results or attractive patterns of working. For the most part, they have not followed the elaboration of a specific theory and although a great deal of subsequent research has been carried out in order to analyse their benefits and limitations, routine practice has been slow to change. The recent reorganization of the health service has yet to exert an appreciable effect on the relationship between the two disciplines. Owing to the newly developing structures and patterns of care, future change is inevitable and brings with it both opportunities and dangers. This paper sets out some of the arguments in favour of a new contract between psychiatry and primary care based on an equal partnership.     

Neurology and psychiatry

This study examined 4,547 workers' compensation claims accepted for hearing-related conditions in Washington state between 1984 and 1991; 80% resulted in disability compensation (n = 3,660). Acute hearing-related conditions comprised 11% of accepted conditions (95% confidence interval [CI], 2-15%); most claims were for chronic noise-related hearing loss. Tinnitus was reported in 64% of accepted claims (95% CI, 54-75%). The median binaural-equivalent hearing loss in compensated claims was 12.5% (inter-quartile interval, 5-22%; 90th percentile, 34%), although it declined by 30% during the study period. The number of claims and associated impairment increased with claimant age, but the number of claims dropped dramatically after age 65. Annual total disability settlements almost tripled in 8 years, totaling $22.8 million. This study indicates that occupational hearing-related conditions: 1) are manifested by mild to moderate hearing loss, accompanied by tinnitus in a majority of cases; 2) may be under-recognized in older, formerly noise-exposed individuals; and 3) were associated with substantial increases in compensation and medical costs over time, through 1991.     

Using homework in psychodynamic psychotherapy.

Homework refers to an assignment given by the therapist to the patient that is to be fulfilled between sessions. It is a typical intervention in cognitive-behavioral therapy, but less common in psychodynamic therapy. This article describes an assimilative, integrative model of psychodynamic therapy that incorporates homework and describes its use in a series of clinical cases. Although the indications for and impact of homework vary from case to case, conclusions are drawn as to the most effective approaches to incorporating homework in a psychodynamic model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of psychodynamic psychotherapy.

Empirical evidence supports the efficacy of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” In addition, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends. Finally, nonpsychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A psychodynamic theory for dental phobia

Dentists recognise various degrees of dental anxiety in their patients. There are those who are relaxed, those who are anxious and those who are dentally phobic. The question remains why should disagreeable dental experiences result in dental anxiety in one patient, have little effect upon another and cause dental phobia in a third? The aim of this paper is to propose a psychodynamic theory for dental phobia based upon the ideas of false connections and displacement.     

The future of psychodynamic psychotherapy.

Discusses the current status and future outlook of psychodynamic psychotherapy. Important trends include (1) increasing attention to disturbances in infancy and early childhood; (2) focusing on more difficult patients; (3) focusing on the dyadic character of the therapeutic relationship; (4) recognition of the importance of the therapeutic alliance; (5) developments in neuroscience and pharmacotherapy; (6) more use of group, marital, and family therapy; (7) emphasis on brief therapy; (8) attempts to devise specific treatments for specific disorders; (9) the appearance of treatment manuals; and (10) the continued search for the mechanisms of change in personality and behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Advances in measures of psychodynamic formulations

Recently published methods are reviewed to assess dynamic formulations derived from psychodynamic case material, especially those methods that emphasize central maladaptive interpersonal patterns. These methods are divided into those that yield psychometric data based on samples that are at least of moderate size and those in which the measures are derived from case studies. The psychometric properties of the first group of measures are reviewed, including interjudge reliability, internal consistency, and content, predictive, and concurrent validity. This article then examines how the measures have addressed and could address the question of construct validity. Also discussed are issues involving the comparison of the methods, particularly their importance for examining specific hypotheses in psychodynamic psychotherapy. Concrete suggestions are made for future research.     

Review of Handbook of evidence-based psychodynamic psychotherapy: Bridging the gap between science and practice.

Reviews the book, Handbook of evidence-based psychodynamic psychotherapy: Bridging the gap between science and practice by Raymond A. Levy and J. Stuart Ablon (see record 2008-14828-000). This book presents a lucid and timely review of research advances assessing the efficacy and effectiveness of psychodynamic psychotherapies in treating many psychological disorders. From research on broad-based meta-analyses of the effectiveness of psychodynamic psychotherapy to close process analysis of therapist and patient interactions, the invited contributors of this volume translate complex research findings into clinically relevant information for clinicians working in the field. The volume is organized to lead the reader from broad-based reviews of psychodynamic psychotherapy outcome studies to examining in-session processes of patient– therapist interactions that affect the patient’s well-being, improvement, and personality change. In all, it lives up to its title and should be added to any clinician’s library. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religion and the adolescent: A psychodynamic perspective.

The adolescent phase of emotional and cognitive development involves attempts, with varying degrees of failure or success, to disengage from primary parental objects and to solidify a sense of identity in terms of both self-image and sexuality. Some of the functions of formal, institutionalized religion are not only to give body to this emergent process by the creation of surrogate parental figures, be they in fantasy or reality, tangible or transcendent, but also to facilitate the completion in adulthood of this variant of a separation–individuation process. Religion also allows for control and aim-inhibited gratification of instinctual drives. The initiation, vicissitudes, and outcome of the theistic–atheistic conflict in adolescence is describe, and case vignettes exemplify this process. Peter Blos's (1984) concept of the incomplete resolution of the negative oedipal conflict in adolescents and its role in neurosogenesis is used as an explanatory hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief psychodynamic and cognitive therapy regarding acute treatment.

Cognitive–behavioral therapy (CBT) and psychodynamic psychotherapy either in their pure forms or possibly synthesized as a form of eclectic therapy appear to be the 2 most commonly utilized forms of psychotherapy, both having levels of empirical support. As the majority of outpatient therapy in America appears to be very brief, 1 reasonable assumption is that treatment is often sought for resolution of acute episodes. A relevant question for practice and clinical training is what are the potential implications with brief psychodynamic and cognitive therapy for this type of treatment? This brief commentary will address the following: (a) the current general differential empirical status of each approach; (b) distinctions between acute treatment and traditional brief therapy and current common treatment patterns; and (c) the general clinical mechanisms for change for each approach and their potential implications regarding acute treatment and clinical supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subliminal psychodynamic activation and the establishment of thresholds.

Comments on J. Balay and H. Shevrin's (see record 1988-20203-001) review of the method of subliminal psychodynamic activation (SPA), which described a number of interpretational problems that made the findings from the SPA paradigm of uncertain value. Moore describes methodological problems in the measurement of perceptual thresholds that appear in SPA as well as in other subliminal paradigms, which may be partly responsible for the inconsistent findings. Mixed findings in SPA research may reflect the fact that different investigators have inadvertently used stimuli that differ widely in their "subliminality." (PsycINFO Database Record (c) 2010 APA, all rights reserved)