Advances in Psychodynamic Psychiatry

Edited by César A. Alfonso, Richard C. Friedman, and Jennifer I. Downey

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November 30, 2018
ISBN 9781462538638
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406 Pages
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Bringing together important articles from Psychodynamic Psychiatry, this volume shows how contemporary practitioners are using a multidimensional biopsychosocial approach to increase the robustness of clinical research and the effectiveness of patient care. Chapters review cutting-edge approaches to formulating anxiety and mood disorders, eating disorders, traumatic grief, substance use and addictive behaviors, obsessive–compulsive disorder, personality disorders, schizophrenia, somatic symptom disorders, and trauma and stressor-related disorders. Treatment of specific populations is addressed, including infants and parents, children, spouses of the chronically ill, survivors of intimate partner violence, criminal offenders, and the elderly. Featuring rich case illustrations, the book integrates psychoanalytic concepts with advances in knowledge about neuroscience, gene–environment interactions, and the physiological impact of adversity.

“This volume offers one of the best overviews of the emerging field of psychodynamic psychiatry that I've seen. Particularly impressive is the coverage of a variety of specific clinical conditions and special populations, as well as attention to ongoing research, including that of a psychobiological nature. I also appreciate the practical emphasis on improving clinical care. This book will be quite valuable as basic reading in psychiatry residency training and continuing medical education courses.”

—Juan E. Mezzich, MD, PhD, Professor of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City


“This is an extraordinary book! It cogently argues against throwing out the baby of viable and useful psychoanalytic ideas with the bathwater of psychoanalytic dogmatism. The conception of psychodynamic psychiatry espoused here is thoroughly modern, integrating psychoanalysis with neuroscience, cognitive psychology, and research, and adopting a positive attitude toward all aspects of psychiatry, including psychopharmacology and diagnosis. The volume includes chapters on all kinds of patients and therapeutic enterprises, each of which emphasizes the importance of following the patient’s narrative without disregarding other important elements. Advances in Psychodynamic Psychiatry is a tour de force that should be required reading throughout the field of mental health.”

—Elizabeth L. Auchincloss, MD, Vice-Chair of Education, Weill Cornell Medical College; Training and Supervising Psychoanalyst, Columbia University Center for Psychoanalytic Training and Research


“The editors have gathered a remarkable group of contributors to portray a new discipline influenced by long-standing ideas. The book is lively and wide ranging, with chapters by major figures in the field. It will help secure the place of psychodynamic psychiatry around the world. This is valuable reading for clinicians, researchers, and especially educators who seek to ensure the continuation of the psychodynamic approach in scarce-resource as well as high-income countries.”

—Helen Herrman, MD, MBBS, President (2017–2020), World Psychiatric Association

Table of Contents

- Foreword, Jennifer I. Downey

- Preface, César A. Alfonso

- Introduction, Richard C. Friedman

I. Psychodynamic Psychiatry—An Emerging Field

1. Psychodynamic Psychiatry and Psychoanalysis: Two Different Models, Richard C. Friedman, César A. Alfonso, & Jennifer I. Downey sample

2. Contemporary Psychodynamic Psychiatry, Richard C. Friedman, Jennifer I. Downey, & César Alfonso

II. A Psychodynamic Approach to Complex Psychiatric Disorders

- Notes, César A. Alfonso

Anxiety Disorders

3. Unmentalized Aspects of Panic and Anxiety Disorders, Fredric N. Busch & Larry S. Sandberg

4. Behind the Mask: A Psychodynamic Exploration of the Experiences of Individuals Diagnosed with Social Anxiety Disorder, Beth McEvoy, John O'Connor, & Odhran McCarthy

Eating Disorders

5. Eating Disorders and Attachment: A Contemporary Psychodynamic Perspective, Giorgio A. Tasca & Louise Balfour

Grief

6. Grieving: The Role of Self-Reorganization, Mardi Horowitz

Internet and Social Networking Excessive Use

7. Psychodynamic Factors Behind Online Social Networking and Its Excessive Use,

Thomas Cheuk Wing Li

Mood Disorders

8. The Psychodynamic Psychotherapist's Guide to the Interaction among Sex, Genes, and Environmental Adversity in the Etiology of Depression for Women, Simone N. Vigod & Valerie H. Taylor

9. Is Increased Sexual Behavior a Symptom of Bipolar Disorder in Children and Adolescents?, Stewart Adelson, Robinette Bell, Adam Graff, David Goldenberg, Elizabeth Haase, Jennifer I. Downey, & Richard C. Friedman

Obsessive–Compulsive Disorder

10. An Integrative Approach to Treatment-Resistant Obsessive–Compulsive Disorder, Luke Sy-Cherng Woon, Anita Kanapathy, Hazli Zakaria, & César A. Alfonso

Personality Disorders

11. Moving Beyond Specialized Therapies for Borderline Personality Disorder: The Importance of Integrated Domain-Focused Treatment, W. John Livesley

12. Borderline Patients: 25 to 50 Years Later, with Commentary on Outcome Factors, Michael H. Stone

13. Pathological Narcissism and the Obstruction of Love, David Kealy & John S. Ogrodniczuk

Schizophrenia

14. Psychotherapy for Schizophrenia: A Review of Modalities and Their Evidence Base,

Michael Brus, Vladan Novakovic, & Ahron Friedberg

Somatic Symptom Disorders

15. A Psychodynamic Perspective on Treatment of Patients with Conversion and Other Somatoform Disorders, Marcia J. Kaplan

Substance-Related and Addictive Disorders

16. Further Evidence of Self-Medication: Personality Factors Influencing Drug Choice in Substance Use Disorders, Lindsey Colman McKernan, Michael R. Nash, William H. Gottdiener, Scott E. Anderson, Warren E. Lambert, & Erika R. Carr

Trauma and Stressor-Related Disorders

17. Psychodynamic Treatment of Combat Veterans with PTSD at Risk for Suicide, Herbert Hendin

18. The Cost of Chronic Stress in Childhood: Understanding and Applying the Concept of Allostatic Load, Debra A. Katz, Ginny Sprang, & Circe Cooke

III. Psychodynamic Psychiatry in Special Populations

- Notes, Richard Friedman & Jennifer Downey

19. Psychodynamic Therapies with Infants and Parents: A Critical Review of Treatment Methods, Björn Salomonsson

20. Childhood Precursors of Personality Disorders: Evaluation and Treatment, Clarice J. Kestenbaum

21. How Clinicians Feel about Working with Spouses of the Chronically Ill, Douglas H. Ingram

22. The Effects of Intimate Partner Violence on Women and Child Survivors: An Attachment Perspective, Alytia A. Levendosky, Brittany Lannert, & Matthew Yalch

23. Psychodynamic Treatment of the Criminal Offender: Making the Case for Longer-Term Treatment in a Longer-Term Setting, Abby L. Mulay, Elspeth Kelly, & Nicole M. Cain

24. Psychotherapeutic/Psychoanalytic Treatment of the Elderly, Joseph Schachter, Horst Kächele, & Judith S. Schachter

IV. Psychodynamic Psychiatry and Neuroscience

- Notes, César A. Alfonso

25. Freud's “Project”: The Mind–Brain Connection Revisited, Myron L. Glucksman

26. The Neurobiology of Attachment: From Infancy to Clinical Outcomes, Joanna Chambers

27. The Role of Oxytocin and Vasopressin in Attachment, C. Sue Carter


About the Editors

César A. Alfonso, MD, Deputy Editor of Psychodynamic Psychiatry, is Clinical Associate Professor of Psychiatry at Columbia University in New York and Visiting Professor at Universiti Kebangsaan Malaysia in Kuala Lumpur. He also teaches at New York Medical College and Northwell Health. His recent work includes the study of the psychodynamic determinants of treatment adherence, the clinical care of persons with low vision and medical multimorbidities, and the design and implementation of psychotherapy training programs.

Richard C. Friedman, MD, Editor-in-Chief of Psychodynamic Psychiatry, is Clinical Professor of Psychiatry at Weill Cornell Medical College, Lecturer in Psychiatry at the Columbia University College of Physicians and Surgeons, and Faculty Member at the Columbia Center for Psychoanalytic Training and Research. His book on male homosexuality was the first to integrate neuroscience, sexology, developmental psychology, and psychoanalytic theory and practice. He began a collaboration with Jennifer I. Downey in 1991 that led to many publications and a book on sexual orientation and psychoanalysis. Drs. Friedman and Downey served as Co-Chairs of the Human Sexuality Committee of the Group for the Advancement of Psychiatry. Dr. Friedman is a recipient of the Mary S. Sigourney Award from the Sigourney Trust. He practices in New York City.

Jennifer I. Downey, MD, Deputy Editor of Psychodynamic Psychiatry, is Clinical Professor of Psychiatry at the Columbia University College of Physicians and Surgeons and Faculty Member at the Columbia Center for Psychoanalytic Training and Research. Dr. Downey has conducted research on sexual orientation in women, Turner Syndrome, and mental health effects of infertility in women, and was the first investigator to demonstrate that sex hormones in homosexual and heterosexual women do not differ. Past president of the American Academy of Psychodynamic Psychiatry and Psychoanalysis, Dr. Downey was the first recipient of the Academy's Victor J. Teichner Award. She was Visiting Professor at the University of Kentucky from 2009–2011. She practices in New York City.

Contributors

Stewart Adelson, M.D., Divisions of Child and Adolescent Psychiatry and of Gender, Sexuality and Health, Columbia University College of Physicians and Surgeons; Weill Cornell Medical College of Cornell University.

César A. Alfonso, M.D., Clinical Associate Professor of Psychiatry at Columbia University, Visiting Professor of Psychiatry at Universiti Kebangsaan Malaysia, and Deputy Editor of Psychodynamic Psychiatry.

Scott E. Anderson, Ph.D., Chief Clinical Officer/Clinical Director at Cornerstone of Recovery, Louisville, Tennessee.

Louise Balfour, Ph.D., Associate Professor at the Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.

Robinette Bell, M.D. (Deceased) Associate Professor of Psychiatry at Columbia University and a member of the Group for the Advancement of Psychiatry, Committee on Human Sexuality.

Michael Brus, M.D., Clinical Instructor of Psychiatry at Icahn School of Medicine at Mt. Sinai, New York.

Fredric N. Busch, M.D., Clinical Professor of Psychiatry, Weill Cornell Medical College and Faculty, Columbia University Center for Psychoanalytic Training and Research.

Nicole M. Cain , Ph.D., Assistant Professor in the Department of Psychology at Long Island University, Brooklyn.

Erika R. Carr, Ph.D., Assistant Professor of Psychiatry at Yale University School of Medicine.

C. Sue Carter, Ph.D., Director of the Kinsey Institute, and Rudy Professor of Biology, Indiana University, Bloomington, Indiana.

Joanna Chambers, M.D., Associate Professor of Clinical Psychiatry, Indiana University School of Medicine and President-Elect of the American Academy of Psychodynamic Psychiatry and Psychoanalysis.

Lindsey Colman McKernan, Ph.D., Assistant Clinical Professor, Vanderbilt University School of Medicine, and works at the Osher Center of Integrative Medicine at Vanderbilt University.

Circe Cooke, M.D., Staff Psychiatrist, New River Valley Community Services, Blacksburg, Virginia.

Jennifer I. Downey, M.D., Clinical Professor of Psychiatry, Columbia University College of Physicians and Surgeons and Faculty Member at the Columbia Center for Psychoanalytic Training and Research; Deputy Editor of Psychodynamic Psychiatry.

Ahron Friedberg, M.D., Clinical Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, New York ; Book Review Editor of Psychodynamic Psychiatry.

Richard C. Friedman, M.D., Clinical Professor of Psychiatry at Weill Cornell Medical School in New York, Lecturer in Psychiatry,Columbia University, and Faculty, the Columbia Center for Psychoanalytic Training and Research; Editor-in-Chief of Psychodynamic Psychiatry.

Myron L. Glucksman, M.D., Clinical Professor of Psychiatry, New York MedicalCollege and Supervising and Training Analyst at the Psychoanalytic Institute of New York Medical College, Valhalla, New York.

David Goldenberg, M.D., Clinical Assistant Professor of Psychiatry, Weill Cornell Medical College, Cornell University; Group for the Advancement of Psychiatry Committee on Human Sexuality.

William H. Gottdiener, Ph.D., Professor, Psychology, John Jay College of Criminal Justice of the City University of New York (CUNY) and Director of Training,clinical psychology doctoral program and the addiction studies program.

Adam Graff, M.D., Chairman, Department of Psychiatry at Northern Arizona Healthcare Flagstaff Medical Center; Group for the Advancement of Psychiatry Committee on Human Sexuality.

Elizabeth Haase, M.D., Assistant Clinical Professor of Psychiatry at Columbia Presbyterian Hospital; Group for the Advancement of Psychiatry Committee on Human Sexuality.

Herbert Hendin, M.D., CEO and Medical Director of Suicide Prevention Initiatives and Professor of Psychiatry at New York Medical College.

Mardi Horowitz, ,M.D., Distinguished Professor of Psychiatry, UCSF School of Medicine in San Francisco.

Douglas H. Ingram, M.D, is Clinical Professor of Psychiatry at New York Medical College.

Horst Kächele,M.D., Ph.D., Professor, International Psychoanalytic University, Berlin, Germany.

Anita Kanapathy, M.B.B.S., Resident, Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia.

Marcia J. Kaplan, M.D., Training and Supervising Analyst, Cincinnati Psychoanalytic Institute and Volunteer Professor of Clinical Psychiatry, University of Cincinnati College of Medicine, Department of Psychiatry.

Debra A. Katz, M.D., Professor of Psychiatry and Neurology, Department of Psychiatry, University of Kentucky College of Medicine.

David Kealy, M.S.W., Clinical Assistant Professor, Psychotherapy Program,Department of Psychiatry, University of British Columbia, Vancouver.

Elspeth Kelly, M.A., Ph.D. candidate, Clinical Psychology, Long Island University, Brooklyn and Mt. Sinai Services/Elmhurst Hospital Elmhurst, NY Adult Psychology Track.

Clarice J. Kestenbaum, M.D., Professor of Clinical Psychiatry, Columbia UniversityCollege of Physicians and Surgeons.

Warren E. Lambert, Ph.D. (Deceased) Vanderbilt Kennedy Center, Vanderbilt University School of Medicine.

Brittany Lannert, Ph.D., Assistant Professor/Clinical Psychologist, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta.

Alytia A. Levendosky, Ph.D., Professor and Director of Clinical Training, Department of Psychology, Michigan State University.

Thomas Cheuk Wing Li, M.B.B.S., F.R.A.N.Z.C.P., psychiatrist in private practice in Hong Kong.

W. John Livesley, M.D., Professor Emeritus, Department of Psychiatry, University of British Columbia, Vancouver; Editor Emeritus, Journal of Personality Disorders.

Odhran McCarthy, M.Psych.Sc, AFPsSI, Reg Psychol PsSI, Principal ClinicalPsychologist–Specialist, Adjunct Professor, Department of Psychology, Trinity College, Dublin, Ireland.

Beth McEvoy, DClinPsych, School of Psychology, Trinity College Dublin.

Abby L. Mulay, M.A., Doctoral Candidate, Clinical Psychology at Long Island University, New York.

Michael R. Nash, Ph.D., Professor of Psychology, Emeritus, The University of Tennessee.

Vladan Novakovic, M.D., Assistant Clinical Professor of Psychiatry, Icahn School of Medicine at Mt. Sinai, New York.

John O'Connor, DClinPsych, Assistant Professor, School of Psychology at TrinityCollege Dublin and Course Director MPhil in Psychoanalytic Studies and MSc in Psychoanalytic Psychotherapy at Trinity College Dublin.

John S. Ogrodniczuk, Ph.D., Professor and Director, Psychotherapy Program, Department of Psychiatry, University of British Columbia, Vancouver.

Björn Salomonsson, M.D., Ph.D., Associate Professor and Psychoanalyst, Department of Women’s and Children’s Health, Karolinska Institute, Stockholm.

Larry S. Sandberg, M.D., Associate Clinical Professor of Psychiatry,Weill CornellMedical College and Faculty, Columbia University Center for Psychoanalytic Training and Research.

Joseph Schachter, M.D., Ph.D., Faculty, Columbia University Psychoanalytic Center for Training and Research

Judith S. Schachter, M.D., Past president of the American Psychoanalytic Association

Ginny Sprang, Ph.D., Professor, College of Medicine, University of Kentucky and Executive Director of the Center on Trauma and Children

Michael H. Stone, M.D., Professor, Clinical Psychiatry, Columbia University College of Physicians and Surgeons

Luke Sy-Cherng Woon, M.D., Resident, Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Center, in Kuala Lumpur, Malaysia

Giorgio A. Tasca, Ph.D, Associate Professor, School of Psychology, Clinical Program, University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario

Valerie H. Taylor, MD, PhD, FRCPC, Psychiatrist-in-Chief, Women’s College Hospital; Scientist, Women’s College Research Institute; and Associate Professor in the Department of Psychiatry, University of Toronto in Ontario, Canada

Simone N. Vigod, MD, MSc, FRCPC, Staff Psychiatrist, Women’s College Hospital; Scientist, Women’s College Research Institute; Associate Professor, Department of Psychiatry, University of Toronto, Ontario, Canada

Matthew Yalch, PhD, Assistant Professor, Clinical Psychology Program, Palo Alto University, Palo Alto, California

Hazli Zakaria,MBBS, Dr. Psych., Lecturer and Head of Clinical Services at the Department of Psychiatry, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia and Vice President of the Malaysian Psychiatric Association

Audience

Psychiatrists, psychoanalysts, and psychodynamic therapists.