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"Doctor I would like to die. Please help."
Psychodynamic Psychiatry Pub Date : 2025-01-22 DOI: 10.1521/pdps.2025.53.1.001
Philip R Muskin
{"title":"\"Doctor I would like to die. Please help.\"","authors":"Philip R Muskin","doi":"10.1521/pdps.2025.53.1.001","DOIUrl":"https://doi.org/10.1521/pdps.2025.53.1.001","url":null,"abstract":"<p><p>The request for hastened death by patients with psychiatric disorders poses a professional conundrum for psychiatrists. Issues of transference and countertransference loom large in such situations. Primitive defense mechanisms, particularly projective identification need to be addressed in understanding the request.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Who's Afraid of Murderous Rage? When Euthanasia Colludes with Self-Destructiveness.
Psychodynamic Psychiatry Pub Date : 2025-01-22 DOI: 10.1521/pdps.2025.53.1.002
Ardalan Najjarkakhaki, Jon Frederickson, Gerrie Bloothoofd
{"title":"Who's Afraid of Murderous Rage? When Euthanasia Colludes with Self-Destructiveness.","authors":"Ardalan Najjarkakhaki, Jon Frederickson, Gerrie Bloothoofd","doi":"10.1521/pdps.2025.53.1.002","DOIUrl":"https://doi.org/10.1521/pdps.2025.53.1.002","url":null,"abstract":"<p><p>The impact of intense countertransference affects in working with patients experiencing complex trauma can have a critical effect on decisions about euthanasia, especially when such decisions are made solely on the grounds of a psychiatric condition. These countertransference dynamics become particularly significant in the context of the rising number of euthanasia requests by psychiatric patients in the Netherlands. We contend that for a subgroup of patients with complex trauma, attachment trauma, and personality disorders, the label \"treatment-resistant\" may be applied prematurely and incorrectly. This may occur when highly complex transference-countertransference dynamics are not properly assessed, and tertiary treatment options like intensive short-term dynamic psychotherapy (ISTDP) are not considered, particularly in cases of chronic and severe childhood trauma leading to an unconscious reservoir of murderous rage that is directed at the self. A long-term therapeutic relationship can activate unconscious transferences, leading to the reenactment of previous attachment trauma. We propose that assessments for euthanasia must include a psychological analysis of the unconscious transference, enactment, and countertransference involved. This article presents a hypothetical case example to illustrate how a patient labeled as \"treatment-resistant\" can be supported through a psychodynamic formulation and proposes further pathways for clinical decision-making.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introduction to the Special Issue of Mentalization-Based Treatment with Children, Adolescents, and Families. 基于心理治疗的儿童、青少年和家庭特刊简介。
Psychodynamic Psychiatry Pub Date : 2024-12-01 DOI: 10.1521/pdps.2024.52.4.425
Efraín Bleiberg
{"title":"Introduction to the Special Issue of Mentalization-Based Treatment with Children, Adolescents, and Families.","authors":"Efraín Bleiberg","doi":"10.1521/pdps.2024.52.4.425","DOIUrl":"https://doi.org/10.1521/pdps.2024.52.4.425","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"52 4","pages":"425-434"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mentalization-Based Work with Families. 以心理为基础的家庭工作。
Psychodynamic Psychiatry Pub Date : 2024-12-01 DOI: 10.1521/pdps.2024.52.4.563
Eia Asen, Efrain Bleiberg, Peter Fonagy
{"title":"Mentalization-Based Work with Families.","authors":"Eia Asen, Efrain Bleiberg, Peter Fonagy","doi":"10.1521/pdps.2024.52.4.563","DOIUrl":"10.1521/pdps.2024.52.4.563","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"52 4","pages":"563-583"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Author Index to Volume 52, 2024. 第 52 卷作者索引，2024 年。
Psychodynamic Psychiatry Pub Date : 2024-12-01 DOI: 10.1521/pdps.2024.52.4.607
{"title":"Author Index to Volume 52, 2024.","authors":"","doi":"10.1521/pdps.2024.52.4.607","DOIUrl":"https://doi.org/10.1521/pdps.2024.52.4.607","url":null,"abstract":"","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"52 4","pages":"607-610"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Information for Authors. 作者须知。
Psychodynamic Psychiatry Pub Date : 2024-12-01 DOI: 10.1521/pdps.2024.52.4.612
{"title":"Information for Authors.","authors":"","doi":"10.1521/pdps.2024.52.4.612","DOIUrl":"https://doi.org/10.1521/pdps.2024.52.4.612","url":null,"abstract":"","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"52 4","pages":"612-614"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recognizing Social Injustice and Epistemic Mistrust in Helping Adolescents with Multiple Needs: The AMBIT (Adaptive Mentalization-Based Integrative Treatment) Approach. 在帮助有多重需求的青少年时认识到社会不公正和认识上的不信任：AMBIT（基于心理适应的综合治疗）方法。
Psychodynamic Psychiatry Pub Date : 2024-12-01 DOI: 10.1521/pdps.2024.52.4.584
Liz Cracknell, Peter Fuggle, Dickon Bevington
{"title":"Recognizing Social Injustice and Epistemic Mistrust in Helping Adolescents with Multiple Needs: The AMBIT (Adaptive Mentalization-Based Integrative Treatment) Approach.","authors":"Liz Cracknell, Peter Fuggle, Dickon Bevington","doi":"10.1521/pdps.2024.52.4.584","DOIUrl":"https://doi.org/10.1521/pdps.2024.52.4.584","url":null,"abstract":"<p><p>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 <i>adaptively</i> 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 <i>caused by</i> social injustice and <i>generate</i> 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.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"52 4","pages":"584-605"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mentalization-Based Treatment for Adolescents (MBT-A). 青少年心理治疗（MBT-A）。
Psychodynamic Psychiatry Pub Date : 2024-12-01 DOI: 10.1521/pdps.2024.52.4.542
Carla Sharp, Trudie Rossouw
{"title":"Mentalization-Based Treatment for Adolescents (MBT-A).","authors":"Carla Sharp, Trudie Rossouw","doi":"10.1521/pdps.2024.52.4.542","DOIUrl":"10.1521/pdps.2024.52.4.542","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"52 4","pages":"542-562"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Working with Parents: A Mentalization-Based Framework. 与家长合作：以心理化为基础的框架。
Psychodynamic Psychiatry Pub Date : 2024-12-01 DOI: 10.1521/pdps.2024.52.4.473
Norka T Malberg
{"title":"Working with Parents: A Mentalization-Based Framework.","authors":"Norka T Malberg","doi":"10.1521/pdps.2024.52.4.473","DOIUrl":"https://doi.org/10.1521/pdps.2024.52.4.473","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"52 4","pages":"473-489"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mentalizing the Clinical High-Risk for Psychosis Model: A Staged Intervention Framework. 心理化临床精神病高危模型：一个分阶段干预框架。
Psychodynamic Psychiatry Pub Date : 2024-12-01 DOI: 10.1521/pdps.2024.52.4.512
Martin Debbané, George Salaminios, Pablo Cascone, Marco Armando
{"title":"Mentalizing the Clinical High-Risk for Psychosis Model: A Staged Intervention Framework.","authors":"Martin Debbané, George Salaminios, Pablo Cascone, Marco Armando","doi":"10.1521/pdps.2024.52.4.512","DOIUrl":"10.1521/pdps.2024.52.4.512","url":null,"abstract":"<p><p>This article seeks to further specify how the mentalization-based approach may inform clinical intervention before the onset of psychosis, that is, during the stage of clinical high-risk for psychosis (CHR-P). We first review the concept of CHR-P, as well as the research evidence of the impact of early intervention. Next, we present evidence for the centrality of mentalizing as a process that may mitigate the risk for psychosis. We then review some of the key contributions in the psychoanalytical and phenomenological traditions concerning the centrality of core self disturbances in psychosis, and relate this to the <i>alien self</i> concept put forward in the mentalization framework. This leads us to expand on the structure of MBT for CHR-P, and to present a clinical vignette illustrating the process of epistemic trust at beginning of an intervention with a young person suffering from CHR-P. We summarize the links between core self disturbances, epistemic trust, and therapeutic communication in the context of CHR-P.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"52 4","pages":"512-541"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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