Psychodynamic Psychiatry最新文献_第2页

Story, Daydreams, and the Default Mode Network. 故事、白日梦和默认模式网络。

Psychodynamic Psychiatry Pub Date : 2026-06-01 DOI: 10.1521/pdps.2026.54.2.188

Richard Brockman

引用次数: 0

Hallucinogen-Assisted Psychotherapy for Trauma Disorders: A Bionian Lens. 致幻剂辅助心理治疗创伤障碍：仿生透镜。

Psychodynamic Psychiatry Pub Date : 2026-06-01 DOI: 10.1521/pdps.2026.54.2.308

Christopher W T Miller, Zofia Kozak

{"title":"Hallucinogen-Assisted Psychotherapy for Trauma Disorders: A Bionian Lens.","authors":"Christopher W T Miller, Zofia Kozak","doi":"10.1521/pdps.2026.54.2.308","DOIUrl":"10.1521/pdps.2026.54.2.308","url":null,"abstract":"There has been an increasing interest in the use of classic psychedelics (such as psilocybin) and 3,4-methylenedioxymethamphetamine (MDMA) for treating mental health conditions. Individuals often describe psychedelic sessions as among the most significant experiences in their lives, emphasizing the sense of awe, connectedness, and spiritual transformation taking place. While the psychedelic literature from the past two decades has mostly focused on using these drugs in the treatment of major depressive, anxiety, and substance use disorders, researchers have also investigated the utility of classic psychedelics and MDMA for other conditions, including trauma- and stressor-related disorders. Trauma can profoundly affect biological systems, including stress hormone pathways and neural circuitry, often leading to hyperarousal and rigid cognitions. In this article, we discuss how some of the concepts posited by Wilfred Bion can be applied to neurobiological models of the mind and to the effects of these drugs. Relevant concepts from neurodevelopment are presented first, including how key areas can be significantly affected by early adversity. This is followed by a discussion of Bion's theory of containment and of how the K link (K denoting knowledge) is developed or disrupted, depending on one's experience. Finally, we present extant literature on the use of MDMA and classic psychedelics in trauma disorders, reflecting on how a Bionian lens can enrich our understanding of their therapeutic action.","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"54 2","pages":"308-337"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259972","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

Psychodynamic Perspectives on Psychedelic States and Treatment Contexts: A Conceptual and Clinical Introduction. 迷幻状态和治疗情境的心理动力学观点：概念和临床介绍。

Psychodynamic Psychiatry Pub Date : 2026-06-01 DOI: 10.1521/pdps.2026.54.2.338

Nadav Liam Modlin, Zsofia Elek, Carolina Maggio, Manish Agrawal, Lauren Lepow, James Rucker, Joanne Stubley, Jeffrey Guss

{"title":"Psychodynamic Perspectives on Psychedelic States and Treatment Contexts: A Conceptual and Clinical Introduction.","authors":"Nadav Liam Modlin, Zsofia Elek, Carolina Maggio, Manish Agrawal, Lauren Lepow, James Rucker, Joanne Stubley, Jeffrey Guss","doi":"10.1521/pdps.2026.54.2.338","DOIUrl":"10.1521/pdps.2026.54.2.338","url":null,"abstract":"Recent clinical trials have suggested the safety and efficacy of psychedelic therapy for treatment-resistant depression, posttraumatic stress disorder, addiction, and end-of-life distress. While neurobiological mechanisms such as 5-HT2A receptor activation, increased neural entropy, and default mode network modulation have been well-characterized, significantly less attention has been given to the emergence of unconscious material within psychedelic states. This article introduces a psychodynamically informed framework for understanding and working with such material in clinical contexts. Drawing on psychoanalytic theory, we explore how psychedelic compounds may facilitate access to preverbal, dissociated, and developmentally embedded psychic content, often expressed through somatic experience, symbolic imagery, and unconstrained affect. Using the four standard phases of psychedelic screening, preparation, psychedelic treatment session, and follow-up or integration, we present a structured psychodynamic lens, integrating conceptual theory with illustrative clinical vignettes. These fictional composites, informed by publicly funded clinical research programs, highlight how unspoken experience, affective intensity, and shifts in psychic structure may unfold within the psychedelic experience. We argue that consideration of unconscious communication, symbolic processes, and defensive functioning can foster greater clinical depth. This article advances the position that psychoanalytic models, though underrepresented in current psychedelic research, offer valuable tools for conceptualizing mechanisms of change beyond symptom reduction. As psychedelic treatments approach regulatory approval and broader clinical use, such perspectives may play an important role in future research, training, supervision, and individualized care models.","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"54 2","pages":"338-372"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260030","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

Adverse Childhood Experiences Increase Vulnerability for Maternal-Infant Bonding Impairment: Examining Psychological and Neuroendocrine Mediational Processes. 不良的童年经历增加了母婴关系损伤的脆弱性：检查心理和神经内分泌的中介过程。

Psychodynamic Psychiatry Pub Date : 2026-06-01 DOI: 10.1521/pdps.2026.54.2.228

Cecilia Martinez-Torteya, Maria Muzik, Sujin Lee, Alyia Levendosky, G Anne Bogat, Joseph S Lonstein, Amy K Nuttall

{"title":"Adverse Childhood Experiences Increase Vulnerability for Maternal-Infant Bonding Impairment: Examining Psychological and Neuroendocrine Mediational Processes.","authors":"Cecilia Martinez-Torteya, Maria Muzik, Sujin Lee, Alyia Levendosky, G Anne Bogat, Joseph S Lonstein, Amy K Nuttall","doi":"10.1521/pdps.2026.54.2.228","DOIUrl":"https://doi.org/10.1521/pdps.2026.54.2.228","url":null,"abstract":"Maternal-infant early bonding, a robust precursor for later healthy infant development, may be jeopardized by maternal early exposures to adverse experiences (ACEs). Both psychological and biological aspects of maternal functioning have been identified as potential putative mechanisms for the deleterious effects of ACEs on maternal-infant bonding, but research has rarely included both in mediation testing, limiting our understanding of the relative contributions of each. We prospectively evaluated the direct and indirect effects of maternal report of ACEs on mother-infant bonding using pregnancy maternal mental health (depression, anxiety, and posttraumatic stress symptoms) and cortisol levels, a marker of HPA-axis functioning. Participants were 446 women recruited from the community; poverty and intimate partner violence (IPV) were overrepresented in our sample. Women completed self-report surveys during their pregnancy and at 1 month postpartum. Baseline cortisol levels were assessed in the laboratory during late pregnancy. A structural equation model to test sequential mediation was estimated and included relevant covariates (race, IPV, traumatic birth). There was a significant indirect effect of ACEs on maternal-infant postpartum bonding via late-pregnancy mental health, but not through maternal late-pregnancy baseline cortisol levels. Our findings underscore the potential for screening and therapeutic intervention addressing depression, anxiety, and PTSD symptoms during pregnancy among women with ACEs history, with benefits that may span two generations and set the stage for a healthy mother-child relationship.","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"54 2","pages":"228-248"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259985","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

It's Not Nature versus Nurture; It's Neural Networks: Adverse Childhood Experiences and Attachment Disruption as Neurodevelopmental Causes of Adult Mental Illness and Addiction. 这不是先天和后天的问题；它是神经网络：不良的童年经历和依恋中断作为成人精神疾病和成瘾的神经发育原因。

Psychodynamic Psychiatry Pub Date : 2026-06-01 DOI: 10.1521/pdps.2026.54.2.199

R Andrew Chambers

{"title":"It's Not Nature versus Nurture; It's Neural Networks: Adverse Childhood Experiences and Attachment Disruption as Neurodevelopmental Causes of Adult Mental Illness and Addiction.","authors":"R Andrew Chambers","doi":"10.1521/pdps.2026.54.2.199","DOIUrl":"https://doi.org/10.1521/pdps.2026.54.2.199","url":null,"abstract":"Neuroscience continues to uncover anatomical, mechanistic, and etiological linkages between mental illness and addiction. The neurodevelopmental pathogenesis of these often intertwined brain disorders is contributed to by both genetic and experiential-causal events. This article introduces the term ecocausatypes to describe traumatically adverse experiences and attachment disruptions that are biologically potent on par with genes, and highly interactive with genetics in causing psychiatric and addiction phenotypes. Neural network theory explains how genotypes and ecocausatypes are biologically integrated, leading to pathological patterns of social-emotional function and motivation in adulthood. At the heart of this pathogenesis, impulsivity is a behavioral feature of motivational neural network dysfunction that is associated with and interlinks disturbances in attachment, trauma-spectrum psychiatric disorders, and addiction vulnerability. On the neural network level, impulsivity is a product of neural wiring and information processing that involves connectivity between the prefrontal cortex, the amygdala, hippocampal formation, and the nucleus accumbens-the primary motivational neural network that is pathologically altered by addictive drugs. Recognizing the effects of ecocausatypes on the development of these frontal cortical-striatal-temporal limbic networks provides a clear understanding of how disordered attachment, trauma-spectrum mental illness, and addiction pathogenesis are biologically and clinically interlinked. This neuroscience has significant implications for training, clinical practice, and research in psychiatry, in which adverse childhood experiences and attachment disruptions are understood as being just as biologically important as genetics, and where medication management and attachment-based psychotherapies are routinely integrated.","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"54 2","pages":"199-227"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259993","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 in Attachment: Understanding the First Relationship Through Neurobiology and Psychodynamics. 依恋中的创伤：通过神经生物学和心理动力学来理解第一关系。

Psychodynamic Psychiatry Pub Date : 2026-06-01 DOI: 10.1521/pdps.2026.54.2.249

Joanna Chambers, Regina Sullivan

{"title":"Trauma in Attachment: Understanding the First Relationship Through Neurobiology and Psychodynamics.","authors":"Joanna Chambers, Regina Sullivan","doi":"10.1521/pdps.2026.54.2.249","DOIUrl":"10.1521/pdps.2026.54.2.249","url":null,"abstract":"Much has been elucidated about the neurobiological effects of early childhood trauma and its transgenerational transmission, although its integration into psychodynamic therapy has been challenging. Here we focus on a common area of interest to both areas-emotion and cognition rooted in past trauma experiences and how these experiences produce maladaptive behaviors transmitted to the next generation through parenting behaviors. We explore two mammalian research paradigms of early-life trauma explicitly within attachment, and transmission of transgenerational pathology through the caregiver to the offspring. We suggest that understanding the neurobiology through this mammalian nonhuman research can provide, in part, an understanding for the complex psychodynamic thought processes seen in adulthood, particularly as the mother begins to raise her own child. Specifically, while cognition and complex conscious and unconscious thoughts are characteristic of the human condition following early-life trauma, the mother-infant attachment system is a phylogenetically preserved system with some basic characteristics seen across species. We outline how embracing both the cognition and preserved trauma neural programing within attachment may provide some insight into cases, especially for the parent-child social interactions well documented to program the brain. Using mother-infant attachment, we suggest there is an area of convergence between clinical psychodynamic focus and basic research in brain function and mechanisms. Focusing on this convergence may provide a unique viewpoint to psychodynamics to supplement diagnosis and treatment.","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"54 2","pages":"249-282"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260016","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

The Frame-In Approach: A Neurobiological and Attachment-Based Model for Managing the Therapeutic Frame in Complex Trauma Treatment. 框架内方法：在复杂创伤治疗中管理治疗框架的神经生物学和依恋为基础的模型。

Psychodynamic Psychiatry Pub Date : 2026-06-01 DOI: 10.1521/pdps.2026.54.2.283

Benjamin S Israel

{"title":"The Frame-In Approach: A Neurobiological and Attachment-Based Model for Managing the Therapeutic Frame in Complex Trauma Treatment.","authors":"Benjamin S Israel","doi":"10.1521/pdps.2026.54.2.283","DOIUrl":"10.1521/pdps.2026.54.2.283","url":null,"abstract":"This article proposes an updated conceptualization of the psychotherapeutic frame, emphasizing its adaptive functions, particularly in the treatment of patients with complex trauma histories or disrupted early attachment relationships. Although conventional views emphasizing the frame's static elements need to be considered, they are insufficient for managing complex relational dynamics, frame departures, impasses, and enactments that commonly arise in treatment with patients who have experienced significant trauma. Integrating insights from attachment theory and the neuroscience of memory systems, this article argues that the frame's interaction with implicit memory systems, especially procedural memory, underlies the frame's therapeutic significance. Departures from the frame are conceptualized primarily as activations of these procedural scripts, often reflecting attempts to navigate relational distress based on past experiences. A systematic, \"frame-in\" approach treatment is proposed, involving monitoring of six core frame constituents-roles, logistics, tasks/boundaries, goals, abstinence from maladaptive behaviors, and safety. This approach facilitates early detection and management of potentially disruptive enactments, protects the therapeutic alliance, helps regulate overwhelming affect, and promotes therapeutic implicit/procedural learning by modifying maladaptive relational patterns within a secure therapeutic framework. The frame-in approach is presented as a specific set of techniques for actively managing the therapeutic alliance, rather than viewing the alliance as a separate construct.","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"54 2","pages":"283-307"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260057","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

Psychodynamic Psychiatry-Information for Authors. 心理动力学精神病学-作者信息。

Psychodynamic Psychiatry Pub Date : 2026-06-01 DOI: 10.1521/pdps.2026.54.2.373

César A Alfonso, Jennifer I Downey

引用次数: 0

The Neurobiology of Trauma: Guest Editors' Introduction. 创伤的神经生物学：客座编辑的介绍。

Psychodynamic Psychiatry Pub Date : 2026-06-01 DOI: 10.1521/pdps.2026.54.2.183

Joanna Chambers, Richard Brockman

引用次数: 0

Life After Retirement, "Re-firement," Un-retirement, and Pre-retirement: Experiences of Four Psychiatrists. 退休后的生活，“再退休”，未退休和退休前：四位精神科医生的经历。

Psychodynamic Psychiatry Pub Date : 2026-03-01 DOI: 10.1521/pdps.2026.54.1.13

H Steven Moffic, Harold Kudler, Alexander Moreira-Almeida, Dilip V Jeste

{"title":"Life After Retirement, \"Re-firement,\" Un-retirement, and Pre-retirement: Experiences of Four Psychiatrists.","authors":"H Steven Moffic, Harold Kudler, Alexander Moreira-Almeida, Dilip V Jeste","doi":"10.1521/pdps.2026.54.1.13","DOIUrl":"10.1521/pdps.2026.54.1.13","url":null,"abstract":"For health care professionals, especially psychiatrists, retirement is not a narrowly defined process. Retirement only means the end of a specific work-related job. It is closely related to aging although the impact of aging on the body and mind varies. In recent decades, there has been growing focus on healthy aging, which is associated with continued professional activity. This article summarizes retirement-related personal experiences described by four psychiatrists who are clinicians and academicians from diverse backgrounds. Three of us have technically retired from our previously titled specific jobs, but all remain markedly active as psychiatrists. Each has a sense of purpose, continues to be productive, and maintains close, positive connections with colleagues and community. The fourth and youngest of us is at least a decade away from retirement and plans to continue life's thrilling journey delightedly. Our experiences exemplify how retirement does not require a health care professional to abandon other vital aspects of their lifelong professional activity and identity, such as learning, helping, serving, caring, reading, writing, teaching, discussing, and understanding. Psychodynamic and positive orientations in particular lead to a strong belief in the need to be an active and compassionate member of the community who helps promote one's own as well as others' well-being. The so-called retirement provides a psychiatrist with the opportunity to ponder, deepen, and savor the adventure of living within the context of an exceptionally broad range of experience with the human condition.","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"54 1","pages":"13-32"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481787","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