Short-term psychodynamic psychotherapy: Reflections on the past and current practice.

Reviews the literature on short-term psychodynamic psychotherapy (STDP) and contends that its roots began with the active therapy of S. Ferenczi. O. Rank laid the foundation for recognition of the importance of personality development in infancy. F. Alexander and T. French challenged analytic concepts but maintained dynamic design. D. Malan systematically studied the process of therapy. P. Sifneos proposed that psychodynamic change involved substituting more adaptive and useful defense mechanisms for maladaptive ones. H. Davanloo felt that persistent challenging of defense made STDP effective even with resistant patients suffering from chronic symptomatic and characterological problems. It is suggested that the aim of STDP is to uncover, reexperience, and work through repressed emotional conflict by means of analysis of defense, resistance, and transference using an active approach. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When it comes to evaluating psychodynamic therapy, the devil is in the details.

Comments on the original article, "The efficacy of psychodynamic psychotherapy," by J. Shedler (see record 2010-02208-012). As Shedler noted, some researchers have reflexively and stridently dismissed psychodynamic therapy (PT) as ineffective without granting outcome studies on this modality a fair hearing. We applaud Shedler’s efforts to bring PT into the scientific mainstream and hope that his article encourages investigators to evaluate claims regarding PT’s efficacy with a more objective eye. Nevertheless, as Shedler also observed, one reason for the scientific community’s premature dismissal of PT is traceable to some psychodynamic practitioners’ historical antipathy toward controlled research and propensity to overstate PT’s efficacy. Regrettably, Shedler falls prey to the latter error by glossing over key methodological details, ignoring crucial findings that run counter to his position, and overstating the quality and quantity of the evidence base for PT. Because of space constraints, we focus only on a handful of the more serious shortcomings of Shedler’s analysis (a more complete review of these issues is available from the first author on request). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implementation of the Rodewisch Theses in East Germany--attempted analysis from the current viewpoint]

We present 3 cases of hemiageusia due to focal ischemic lesions in the brainstem. Clinical presentation with discrete localization of these lesions suggests that the central taste pathway in humans projects ipsilaterally from the solitary nucleus up to the level of the upper pontine or lower midbrain before decussation. Associated partial sensory disturbance of the face or limb with lack of evidence of medial lemniscus decussation at the upper brainstem suggests that the medial lemniscus may not directly convey taste sensation.     

"Systematic empirical investigation of vulnerability to postpartum depression from a psychodynamic perspective": Reply to Besser et al.

I appreciate the thoughtful and constructive comments Besser et al. (see record 2008-03991-016) have offered regarding the original article (see record 2007-00135-004) and mention some thoughts for further consideration concerning the relationship between empirical research and clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neurorehabilitation/geriatric rehabilitation--goals achieved and aims from the viewpoint of the so-called "Vorarlberg Model"

Together with building up a first neurological department in one of the Austrian states we could introduce and organize the 1st scientific institute in literature for neuro-rehabilitation and -prophylaxis. 80% of the neuro-rehabilitation-patients are geriatrics. Hence overlapping of neuro-rehabilitation with rehabilitation in old age is to be postulated. "Rehabilitation of old age groups" as well has been named by us for the 1st time in scientific literature. Moreover we operate such activities on a large scale within a practical and social medical context. As worldover (at least within the civilized countries of high standards) the problem of old age groups is a steadily increasing and important, we are working on a very important scientific sector. Our slogan: "Holistic and permanent" is practically operated as follows: 1. Fluent transition of rehabilitation-adequate acute treatment towards a systematic specialized rehabilitation. 2. Schooling of relatives and follow up rehabilitation service. 3. Introducing rehabilitative thoughts as well in university, teaching as (by separate schoolings) within medical profession and all the other health professions. 4. We emphasize a plurality of methods; to be named here as main examples: integrated physiotherapy as well as integrated psychotherapy. Emphasizing more scientific values for (high age-)rehabilitation, we emphasize as well that it must not be banned into "high age ghettos". Contrarely rehabilitation adapted thinking must be integrated within all the health professions. 5. Innovation, phantasy and pleasure must be introduced into our work. We report of work with lay-groups, animal-visits, hippo-therapy, music, etc. This forms a large interesting territory for an upraising young generation in health professions.     

Methods and mechanisms in the efficacy of psychodynamic psychotherapy.

Comments on the original article, "The efficacy of psychodynamic psychotherapy," by J. Shedler (see record 2010-02208-012). Shedler summarized a large body of research that shows psychodynamic therapy to have a substantial effect size, comparable to that for many empirically supported treatments. This is an important finding, in part refuting the concerns raised by Bornstein (2001, 2002) regarding the future of psychodynamic approaches had there been no substantial changes in how practitioners and researchers approached the science to demonstrate efficacy. Further, Shedler showed that the efficacy of psychoanalytic psychotherapy is due to therapeutic methods commonly employed in cognitive behavior therapy (CBT), one of the most frequently cited empirically supported approaches for a wide range of psychological conditions. From a methodological perspective, there are some important limitations to the claim of psychodynamic psychotherapy’s comparable efficacy to other empirically supported approaches. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of a "reformed sinner" and a "lapsed saint" strategy upon trust formation in paranoid and nonparanoid schizophrenic patients.

Compared paranoid and nonparanoid schizophrenic patients, as well as a normal sample, on: (1) capacity to form a trusting relationship with an unknown other, and (2) the relative efficacy of a "reformed sinner" vs. a "lapsed saint" strategy in inducing trusting and trustworthy behavior in these samples. 48 Ss played a 2-person bargaining game for 30 trials and were randomly assigned to 1 of 2 strategies. Several game-playing styles differentiated the 3 samples. The paranoids, as contrasted with the nonparanoids and 24 normals, were more likely to be "cooperative" when dealing with a lapsed saint and more "exploitative" when confronted with a reformed sinner. Results reflect the paranoids' conflicting attitudes toward discrepancies in power. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is There a Window of Heightened Suicide Risk If Patients Gain Energy in the Context of Continued Depressive Symptoms?

The authors' purpose is to provide some empirical perspective on the important but understudied possibility that when people become more energetic in the context of continued depressive symptoms, suicide risk escalates. The authors studied 109 suicidal young adults; among those who initially reported substantial depression, a subgroup was identified whose energy was increasing in context of continued depressive symptoms. They were compared with others with regard to suicidality 1 month later. Results suggested that those who have incomplete remissions (of any sort) may be more ill to begin with, and this may account for higher suicide risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple personality disorder: Etiology, treatment, and treatment techniques from a psychodynamic perspective.

Academic psychologists have moved away from psychoanalytic and psychodynamic explanations of human functioning and pathology and have instead embraced neuropsychology and cognitive science. This trend has kept many psychologists and researchers from more fully understanding some of the important phenomena they chose to investigate. One area about which psychologists can learn in the psychodynamic literature is multiple personality disorder (MPD). A thorough knowledge of the psychodynamic perspective with regards to MPD is important to all those in psychology who deal with MPD patients or who study the phenomenon. By understanding the abuse most of these patients suffered and the resulting impact this has had on their personality development, psychologists can begin to create effective and promising assessment tools and intervention programs. In this article, I review MPD and its treatment from a psychodynamic perspective in hopes that those in psychology (researchers and clinicians alike) may benefit from such a discussion and will utilize this information in their attempts to understand MPD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biography and psychodynamic theory: Some lessons from the life of Francis Galton.

The case of Francis Galton illustrates that a psychologically oriented biographer must be opportunistic in selecting which psychodynamic theories to use because such choices are inevitably constrained by the nature of the available data. The data from Galton's childhood, though copious, are more usefully dealt with from an Adlerian than a Freudian perspective. Galton's theory of innate and hereditary intellectual differences is derived at least partly from his sense of personal inferiority, and his scientific and literary style is related to his birth order position as a youngest child. For interpretation of Galton's responses to the stresses of medical training in adolescence, the Freudian conception of ego defense mechanisms proved useful. The few available hints regarding his sexuality are possibly related to a midlife crisis he experienced in the 1860s, which culminated in his inspiration for eugenics. The article concludes with a discussion of the general nature, advantages, and limitations of the personality theories available to a biographer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"I didn't do it:" Responsibility biases in open and closed groups.

Group members often take more responsibility for the group's outcomes than others give to them. Extending evidence that egocentrism can be muted when group members are individuated (the "unpacking effect"), the authors predicted that members of open groups would be less egocentric than members of closed groups. In open groups, the possibility of membership fluctuation reduces collectiveness, breaking the group into individuals, which in turn lessens egocentrism. The authors tested these predictions in a study of groups of students working on a task relevant to their academic success. Members claimed more personal responsibility when they worked in closed groups relative to open groups (egocentrism), and lack of cohesion mediated the open- versus closed-group link to responsibility allocations. Moreover, members of open groups did not take more responsibility after a success than a failure, whereas those in closed, successful groups claimed more credit than members of failure groups (self-serving bias). The discussion suggests that open groups, although often thought to create conflict as members compete, may contribute to a reduction in both egocentrism and self-serving responsibility allocations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Compulsory treatment in psychiatry from the viewpoint of the patient. A prospective study

During a 6-month period all patients who had been treated involuntarily in a state-funded mental mental health unit were studied prospectively. They were interviewed after the first compulsory measure and at the end of treatment. A control group of patients (not experiencing involuntary treatment) were interviewed as well. The aim of the study was to establish whether the groups differed with respect to judgement of subjective well-being and satisfaction with treatment. The stability of these judgements over time and especially changes in perception and acceptance of involuntary treatment during the course of treatment were also monitored. the 36 patients in the study group perceived themselves as being far less ill at both time points and were less satisfied with treatment than the 29 control patients. At the end of treatment, all patients judged themselves to be significantly more ill retrospectively and patients of the study group were more satisfied with treatment than at the beginning. When questioned in the days after an involuntary measure, 25% of the patients concerned denied that any measure had taken place against their will; at the end of the hospital stay this figure had increased to 42%. In contrast, four control patients complained that they had been involuntarily subjected to treatment. In discordance with the previously published literature, the acceptance of involuntary treatment declined over time.     

Key competencies of the psychodynamic psychotherapist and how to teach them in supervision.

Four of Rodolfa et al.’s (2005) competencies in professional psychology—relationship, self-reflection, assessment-case conceptualization, and intervention—are key for the psychodynamic psychotherapist. Relationship lies at the heart of what is understood to be curative about psychodynamic psychotherapy. Self-reflection implies a complex and highly developed process that includes but goes beyond Rodolfa et al.’s and Kaslow, Dunn, and Smith’s (2008) definitions. Competent assessment, diagnosis, and case conceptualization entails making inferences about unconscious processes by observing the client and also one’s own experience, and integrating these inferences with theory. Effective psychodynamic intervention is derived from what the psychotherapist has experienced, processed, and conceptualized about the relationship with the client and about the client’s internal object world. An extended vignette shows these competencies emerging in a psychotherapist-in-training, facilitated by an intense interaction with a supervisor. Although the supervisory and clinical tasks are different, the supervisor provides a relationship experience that models these same competencies for the supervisee and catalyzes their development in the supervisee. (PsycINFO Database Record (c) 2010 APA, all rights reserved)