Concise Guide to Psychodynamic Psychiatry

Concise Guide to Psychodynamic Psychiatry

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In a world of multiple treatments for psychiatric illness, the beginning therapist may have a limited psychoanalytic background in psychodynamic treatment modalities. Psychodynamic psychotherapy can be an important part of the clinician's therapeutic armamentarium. "Concise Guide to Psychodynamic Psychotherapy" introduces the clinician to the concepts and techniques of psychoanalytic psychotherapy. The guide is written from the perspective of the conscientious skilled clinician. With case vignettes included in each chapter, this text is expressly written for clinicians who seek the most helpful treatments for the pain and suffering of their patients with psychiatric illness. Chapter 1 includes an introduction that reviews the focus of psychodynamic psychotherapy. This chapter describes the setting of psychodynamic psychotherapy by discussing the length of treatment and how often sessions should be held; and suggests techniques of psychodynamic psychotherapy evaluation. It provides guidelines for beginning the evaluation, such as the number and length of evaluation sessions, and describes methods for collecting data during the evaluation.
The psychodynamic assessment and selection criteria are also covered in this chapter. Chapter 3 reviews techniques for beginning treatment. Teaching the patient about the goals and process of psychodynamic psychotherapy is important to the successful beginning of the psychotherapy. This chapter talks about education and learning. After the patient has begun to understand the process of treatment, the therapist will, over time. become somewhat less verbally active in order to hear more about how the patient organizes his or her psychological world. Abstinence and free association are also covered. Resistance and defense refer to the forces within the patient that oppose the aims of treatment. Every patient is ambivalent about getting well. Chapter 4 takes a look at resistance and defence by focusing on the defense mechanisms. Chapter 5 examines transference in psychodynamic psychotherapy, the different forms, working with transference in psychotherapy, and erotic and aggressive trensferences in psychotherapy. Countertransference is the topic of Chapter 6.
Beginning with a definition of countertransference, this chapter covers concordant and complementary countertransference, countertransference and borderline personality disorder. The clinical use of dreams in dynamic psychotherapy offers the psychiatrist many opportunities to assist the patient in developing an understanding of how the mind works. Chapter 7 shows how dream analysis can be an important vehicle in helping the patient develop skills in ongoing self-inquiry. There comes a time when the patient and the psychiatrist agree to end the treatment. Chapter 8 shows how to know when the end is near, provides guidelines regarding the tasks involved with the termination phase, and suggests how to handle unsuccessful treatment. Chapter 9 takes a look at practical problems that may arise when a therapist uses psychodynamic psychotheapy. Tips on office decor; questions about fees and medical insurance; and advice on what to do when patients call between sessions, scheduling vacations, and handling suicidal patients are just a few of the issues discussed. Chapter 10 reviews the use of brief psychotherapy. Brief psychotherapy is now a necessary part of every clinician's skills.
Selection, treatment, termination and techniques are discussed. Borderline, schizoid and narcissistic personality disordered patients constitute a difficult and challenge population both for the beginning therapist and the seasoned clinician. Chapter 11 provides guidelines for treating such individuals. Chapter 12 focuses on the role of supportive psychotherapy in helping the patient reestablish his or her previous best level of functioning. This chapter discusses selection of patients who can benefit from this approach, and techniques to use when administering supportive psychotherapy.
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Product details

  • Paperback | 176 pages
  • American Psychiatric Press Inc.
  • VA, United States
  • index
  • 0880483377
  • 9780880483377

Table of contents

Part 1 Introduction: the focus, setting and technique of psychodynamic psychotherapy. Part 2 Patient evaluation: beginning the evaluation; selection criteria. Part 3 Beginning treatment: education and learning; abstinence and free association; the atmosphere of safety; the attitude of physicianly concern; disappointment in the opening phase; the early experience of transference, defence and resistance; initial use of dreams in therapy. Part 4 Resistance and defence: resistance; defence; interpreting resistance and defence mechanisms; transference resistance. Part 5 Transference: the need to repeat the past; transference in psychodynamic psychotherapy; forms of transference; working with the transference; transference as a resistance; erotic and aggressive transferences; working through the transference. Part 6 Countertransference: concordant and complementary countertransferences; countertransferences in work with boderline personality disorder; other countertransferences; the therapist's need for personal psychoanalysis and supervision. Part 7 Dreams: introducing the patient to the use of dreams; use of dreams during the middle phase of therapy; use of dreams during the latter phases of therapy; the dream as an indicator of unconcious conflict; the dream as an indicator of transference; the termination dream; words of caution. Part 8 Termination: recognizing when the termination phase is approaching; tasks of the termination phase - reviewing the treatment; experiencing the loss of psychotherapy and the therapist; re-experiencing and remastering the transference; increasing skills in self-inquiry as a method of problem solving; disappointment in the termination phase; when the treatment is unsuccessful; leave-taking - the reactions of the therapist. Part 9 Practical problems and their management: the office - decor and setting fees; medical insurance; phone calls; scheduling vacations; suicidal patients; dangerous patients; gifts; advices - the psychotherapist as physician; illness in the patient; therapist errors; general guidelines. Part 10 Brief psychodynamic psychotherapy: selection; duration of treatment and termination techniques. Part 11 Psychotherapy of borderline personality disorder and other severe character pathology: diagnosis; conflicts; beginning psychotherapy; psychotherapeutic work with the borderline pathient's defenses; countertransferences; narcissistic and schizoid patients. Part 12 Supportive psychotherapy: selection; techniques.
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