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Clarification: A Powerful Therapeutic Strategy in Psychodynamic Psychotherapy. 澄清：心理动力学心理治疗中的一种强有力的治疗策略。
Psychodynamic Psychiatry Pub Date : 2025-06-01 DOI: 10.1521/pdps.2025.53.2.172
Milton Viederman
{"title":"Clarification: A Powerful Therapeutic Strategy in Psychodynamic Psychotherapy.","authors":"Milton Viederman","doi":"10.1521/pdps.2025.53.2.172","DOIUrl":"https://doi.org/10.1521/pdps.2025.53.2.172","url":null,"abstract":"<p><p>This article addresses the question of how individuals construct their picture of reality and develop a sense of meaning in their lives. This question is pertinent to effecting and understanding change in the process of psychodynamic psychotherapy and psychoanalysis. Three themes are explored. The description and utilization of a particular form of clarification that is not described in the psychoanalytic literature is followed by an illustration of how this form of clarification creates order and cohesion in one's life. This is further developed by a discussion of how the philosophical concept of constructivism enriches this awareness. Patient anecdotes illustrate these themes.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"53 2","pages":"172-183"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200357","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
Trauma, Epigenetic Alterations, and Psychotherapy. 创伤、表观遗传改变和心理治疗。
Psychodynamic Psychiatry Pub Date : 2025-06-01 DOI: 10.1521/pdps.2025.53.2.143
Shabnam Nohesara, César A Alfonso
{"title":"Trauma, Epigenetic Alterations, and Psychotherapy.","authors":"Shabnam Nohesara, César A Alfonso","doi":"10.1521/pdps.2025.53.2.143","DOIUrl":"https://doi.org/10.1521/pdps.2025.53.2.143","url":null,"abstract":"<p><p>Psychotherapy was until recently described from a biological standpoint as causing structural changes in the brain and physiological alterations of neurotransmission pathways. Current research recognizes that psychotherapy also causes changes at the level of the DNA, with alterations in epigenetic mechanisms that correlate with symptom reduction and treatment response. The authors provide a brief overview of the evolving research in epigenetics, highlighting the association between trauma, DNA methylation patterns of specific gene regions, and psychiatric disorders. They also review several studies that show that various evidence-based psychotherapy interventions recalibrate these DNA methylation abnormalities. Finally, they identify studies that measured DNA methylation of BDNF and HTR3A genes and suggest that these may serve as biological markers of response to psychotherapy.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"53 2","pages":"143-150"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200267","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
Can Graduate Students Rate Personality Reliably in Psychoanalytic Treatments Using the Shedler-Westen Assessment Procedure (SWAP-200)? 研究生在使用shedler - western评估程序（SWAP-200）进行精神分析治疗时能否可靠地评价人格？
Psychodynamic Psychiatry Pub Date : 2025-03-01 DOI: 10.1521/pdps.2025.53.1.102
Daniel S Spina, Katie Aafjes-van Doorn, Sarah J Horne, Francesco Gazzillo, Federica Genova, Bernard S Gorman, Karl Stukenberg, Sherwood Waldron
{"title":"Can Graduate Students Rate Personality Reliably in Psychoanalytic Treatments Using the Shedler-Westen Assessment Procedure (SWAP-200)?","authors":"Daniel S Spina, Katie Aafjes-van Doorn, Sarah J Horne, Francesco Gazzillo, Federica Genova, Bernard S Gorman, Karl Stukenberg, Sherwood Waldron","doi":"10.1521/pdps.2025.53.1.102","DOIUrl":"10.1521/pdps.2025.53.1.102","url":null,"abstract":"<p><p><b>Introduction:</b> Psychotherapy researchers often recruit students to code psychotherapy process and outcome variables on individual therapy sessions. To do so, graduate students read verbatim psychotherapy transcripts, listen to audio or watch video of psychotherapy sessions, and then rate process and outcome measures on these sessions. Although prior studies have investigated the reliability and validity of graduate student ratings of personality dysfunction, no current study has investigated the reliability and validity of these ratings made on the basis of psychotherapy transcripts and audio. In this study, we evaluated the degree to which graduate students can reliably and validly code observer-rated personality assessments on the Shedler-Westen Assessment Procedure-200 (SWAP-200). <b>Methods:</b> We related graduate student and experienced clinician-researcher's SWAP-200 scores in an existing dataset of 27 patients undergoing psychoanalytic psychotherapy at early and late phases of treatment. <b>Results:</b> Using truth and bias multilevel models, we found that graduate students tended to underestimate personality pathology at the early phase of treatment and overestimate pathology at the late phase in treatment. These responses resulted in smaller effect sizes in the graduate student ratings, such that patients' personality functioning did not appear to change following treatment. By contrast, the experienced clinician's scores supported moderate to large effect sizes in personality change. <b>Discussion:</b> These deviations from expert judgment may have significant ramifications for evaluating pre and post effect sizes in psychotherapy process studies using graduate student coding. Suggestions for research and practice are discussed.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"53 1","pages":"102-120"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651206","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
Erratum. 勘误表。
Psychodynamic Psychiatry Pub Date : 2025-03-01 DOI: 10.1521/pdps.2025.53.1.140
{"title":"Erratum.","authors":"","doi":"10.1521/pdps.2025.53.1.140","DOIUrl":"https://doi.org/10.1521/pdps.2025.53.1.140","url":null,"abstract":"","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"53 1","pages":"140"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651253","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
"Doctor I would like to die. Please help." “医生，我想死。请帮。”
Psychodynamic Psychiatry Pub Date : 2025-03-01 Epub 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":"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":"18-21"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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
A Process for Development of a Psychodynamic Psychotherapy for Borderline Personality Disorder Learning Module for Psychiatry Residents. 精神科住院医师边缘型人格障碍心理动力治疗学习模块的开发过程。
Psychodynamic Psychiatry Pub Date : 2025-03-01 DOI: 10.1521/pdps.2025.53.1.79
Petrin Redayani Lukman, Tjhin Wiguna, Diantha Soemantri, Sri Linuwih Menaldi, Sylvia Detri Elvira, Limas Sutanto, Tuti Wahmurti A Sapiie, Aria Kekalih, Reina Rahma Noviasari, Hukma Shabiyya Rizki, Kharisma Zatalini Giyani
{"title":"A Process for Development of a Psychodynamic Psychotherapy for Borderline Personality Disorder Learning Module for Psychiatry Residents.","authors":"Petrin Redayani Lukman, Tjhin Wiguna, Diantha Soemantri, Sri Linuwih Menaldi, Sylvia Detri Elvira, Limas Sutanto, Tuti Wahmurti A Sapiie, Aria Kekalih, Reina Rahma Noviasari, Hukma Shabiyya Rizki, Kharisma Zatalini Giyani","doi":"10.1521/pdps.2025.53.1.79","DOIUrl":"10.1521/pdps.2025.53.1.79","url":null,"abstract":"<p><p><b>Introduction:</b> Psychodynamic psychotherapy is an effective treatment for borderline personality disorder (BPD), but few specific curricula for psychiatric residents currently exist. The authors developed an online learning module to teach psychodynamic psychotherapy for BPD to psychiatry residents, based on the following educational methods: the ADDIE (analysis, design, development, implementation, evaluation) design process, the Morrison, Ross, and Kemp instructional design model, and the 4C/ID (four-components instructional design) model. <b>Methods:</b> Indonesian residents, psychiatrists, and psychotherapy teaching staff participated in a needs analysis to identify the competencies, subject content, and learning methods that the module should address, through focus group discussions and Delphi survey methodology. The module then underwent content validation. <b>Results:</b> The psychodynamic psychotherapy for BPD learning module was designed as a 12-session online training program. The module addresses three main subjects: phenomenology and pathogenesis of BPD, basic principles of psychodynamic psychotherapy, and the practice of psychodynamic psychotherapy with patients with BPD. It is taught through lectures, case discussions, video discussions, psychodynamic formulation learning assignments, and a review of residents' process notes of psychodynamic psychotherapy sessions. <b>Discussion:</b> Implementation of this module could enhance residents' competency to treat BPD with psychodynamic psychotherapy and fill the current gaps in the field of psychotherapy education, especially in areas of the world with limited access to expert faculty.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"53 1","pages":"79-101"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651186","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
Moving beyond Personality Disorders: A Challenge for the DSM-6. 超越人格障碍：对DSM-6的挑战。
Psychodynamic Psychiatry Pub Date : 2025-03-01 DOI: 10.1521/pdps.2025.53.1.22
Jacob E Perlson, Claire Koljack, Jack Drescher, Deborah L Cabaniss
{"title":"Moving beyond Personality Disorders: A Challenge for the <i>DSM-6</i>.","authors":"Jacob E Perlson, Claire Koljack, Jack Drescher, Deborah L Cabaniss","doi":"10.1521/pdps.2025.53.1.22","DOIUrl":"10.1521/pdps.2025.53.1.22","url":null,"abstract":"<p><p>The authors argue that as a diagnostic category \"personality disorders\" falls short in offering helpful counsel to patients with difficulties in self and interpersonal functioning. The article begins with a discussion of <i>symptom</i> versus <i>disorder</i> in general medicine before critiquing the impulse of psychiatrists and humans more broadly to categorize and sort. The authors summarize well-described limitations to categorical personality disorder diagnoses, including their questionable clinical utility, unsteady empirical support, and potential to reify myriad forms of stigma. These limitations emphasize the multidimensionality of personality and bring attention to the potential harms of offering patients diagnoses so laden in negative judgements, particularly when working with minoritized patient populations. The authors advocate for a reconsidered dimensional approach that may be emphasized in future editions of the <i>Diagnostic and Statistical Manual of Mental Disorders</i> (DSM).</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"53 1","pages":"22-26"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651255","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
Anger in the Therapeutic Space: Healing through the Attitude of Equanimity. 治疗空间中的愤怒：通过平静的态度进行治疗。
Psychodynamic Psychiatry Pub Date : 2025-03-01 DOI: 10.1521/pdps.2025.53.1.39
Michael Uebel
{"title":"Anger in the Therapeutic Space: Healing through the Attitude of Equanimity.","authors":"Michael Uebel","doi":"10.1521/pdps.2025.53.1.39","DOIUrl":"10.1521/pdps.2025.53.1.39","url":null,"abstract":"<p><p>In the consulting room, the existence of anger-a perfectly normal human emotion-is less a concern than our relationship to it, whether our own or our patients'. The ways we frame difficult emotions like anger and how we encourage our patients to hold them are crucial to the task of psychological healing. Offered here are some reflections, situated at the crossroads of psychodynamic theory and Buddhist thought, on how such healing may be rooted in the attitude of equanimity.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"53 1","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651191","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
2024 Reviewers for Psychodynamic Psychiatry. 2024年精神动力精神病学评审员。
Psychodynamic Psychiatry Pub Date : 2025-03-01 DOI: 10.1521/pdps.2025.53.1.139
{"title":"2024 Reviewers for <i>Psychodynamic Psychiatry</i>.","authors":"","doi":"10.1521/pdps.2025.53.1.139","DOIUrl":"https://doi.org/10.1521/pdps.2025.53.1.139","url":null,"abstract":"","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"53 1","pages":"139"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651183","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. 谁害怕杀人狂怒？当安乐死与自我毁灭相勾结。
Psychodynamic Psychiatry Pub Date : 2025-03-01 Epub 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":"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":"45-60"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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
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