Neil Krishan Aggarwal, Amarjit Singh Dulat, General Asad Durrani
{"title":"How Psychoanalytic Theory and Track II Diplomacy Can Inform Each Other: A Dialogue with the Former Heads of India and Pakistan's Foreign Intelligence Agencies.","authors":"Neil Krishan Aggarwal, Amarjit Singh Dulat, General Asad Durrani","doi":"10.1521/pdps.2023.51.1.25","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.25","url":null,"abstract":"<p><p>Starting with Sigmund Freud, psychoanalysts have considered the psychological dimensions of peacemaking in international relations. In the 1980s, psychiatrists, psychologists, and diplomats began developing theories on Track II negotiations, defined as unofficial meetings among influential stakeholders with access to government policymakers. In recent years, psychoanalytic theory building has waned with the decline of interdisciplinary collaborations among mental health professionals and practitioners of international relations. This study seeks to revive such collaborations by analyzing the reflections of an ongoing dialogue between a cultural psychiatrist trained in South Asian studies, the former head of India's foreign intelligence agency, and the former head of Pakistan's foreign intelligence agency on applications of psychoanalytic theory to Track II initiatives. Both former heads have participated in Track II initiatives to build peace between India and Pakistan and agreed to react on the record to a systematic review of psychoanalytic theories on Track II. This article describes how our dialogue can offer new directions for theory building and the practical conduct of negotiations.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"25-44"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506783","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}
{"title":"The Therapeutic Relationship: Intrapsychic and Behavioral Changes in Both Patient and Analyst.","authors":"Myron L Glucksman","doi":"10.1521/pdps.2023.51.1.63","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.63","url":null,"abstract":"<p><p>This article explores how the therapeutic relationship facilitates intrapsychic and behavioral changes in both the patient and the analyst. Key elements of the therapeutic relationship are reviewed, including transference, countertransference, introjective and projective identification, as well as the \"real relationship.\" Special attention is paid to the \"transformative relationship,\" which is a special kind of bond that develops between analyst and patient that is unique and transformative. It consists of mutual respect, emotional intimacy, trust, understanding, and affection. Empathic attunement is a key element in the evolution of a transformative relationship. This attunement optimally promotes intrapsychic and behavioral changes in both the patient and the analyst. This process is illustrated by a case presentation.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"63-75"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9491380","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}
{"title":"When the Psychiatrist Morally Disapproves.","authors":"Keng Chuan Soh, Jocelyn Siling Liao, Yi Hang Tay","doi":"10.1521/pdps.2023.51.1.15","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.15","url":null,"abstract":"<p><p>The understanding of concepts like moral distress and countertransference in mental health settings has advanced over time. While organizational constraints and the clinician's moral values are conventionally thought to play a part in evoking such responses, certain behavioral transgressions might be universally deemed as morally unacceptable. The authors present case scenarios that took place during forensic assessments and routine clinical care. Clinical interactions evoked a diverse range of negative emotional reactions, including anger, disgust, and frustration. The clinicians struggled with moral distress and negative countertransference, which resulted in difficulty mobilizing empathy. Such responses could affect a clinician's ability to best work with the individual and could even affect the clinician's well-being adversely. The authors put forth several suggestions on how to manage one's own negative emotional reactions in similar settings.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506782","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}
{"title":"Examining Anti-Racism Efforts in Psychiatry Residency Programs.","authors":"Justin Reynard Smith","doi":"10.1521/pdps.2023.51.1.6","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.6","url":null,"abstract":"<p><p>High-profile instances of police and citizen brutality against Black people in the United States in 2020 spurred increased attention to longstanding racial injustice, leading to widespread adoption of anti-racism concepts, discussions, and efforts. Due to the relative infancy of anti-racism agendas on an organizational level, effective anti-racism strategies and best practices are still being developed. The author-a Black psychiatry resident-aims to contribute to the anti-racism efforts and discourse happening nationally within medicine and psychiatry. A personal account is given reviewing challenges and successes from recent anti-racism efforts on the organizational level of a psychiatry residency program.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"6-14"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506785","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}
{"title":"Psychosocial and Psychodynamic Considerations Informing Factitious Disorder.","authors":"Anna L Dickerman, Xavier F Jiménez","doi":"10.1521/pdps.2023.51.1.98","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.98","url":null,"abstract":"<p><p>Factitious disorder is a condition in which patients deceitfully present themselves as injured or ill in the absence of obvious external reward. It is difficult to diagnose and treat, and little rigorous evidence exists in the literature. While larger studies have revealed some clinical and sociodemographic patterns, there is a lack of consensus on psychosocial factors and mechanisms contributing to factitious disorder. This in turn has led to conflicting recommendations on management. In this article, we review major psychopathological theories of factitious disorder, including the role of early trauma and subsequent development of interpersonal dysfunction, as well as maladaptive gratification obtained from assuming the sick role. Common themes of interpersonal disruptions in this patient population include a pathologic need for attention and care, as well as aggression and desire for dominance. In addition to psychodynamic and psychosocial etiologic models of factitious disorder, we also review associated treatment approaches. Finally, we offer clinical implications, including countertransference considerations, as well as directions for future research.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"98-113"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506777","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}
John S Ogrodniczuk, David Kealy, Daniel W Cox, Michał Mielimąka, Anthony S Joyce
{"title":"A Preliminary Study of the Interactive Effect of Avoidant Personality Disorder Symptoms and Expressive Suppression on the Outcome of a Psychodynamically Oriented Day Treatment Program.","authors":"John S Ogrodniczuk, David Kealy, Daniel W Cox, Michał Mielimąka, Anthony S Joyce","doi":"10.1521/pdps.2023.51.1.114","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.114","url":null,"abstract":"<p><p><i>Introduction:</i> Patients with avoidant personality disorder (AvPD) pathology tend to have poor prognosis in psychotherapy, yet there has been little research conducted to better understand why their outcomes are limited, making it difficult to improve treatments for them. Expressive suppression is a dysfunctional emotion regulation strategy that may exacerbate avoidant tendencies, further complicating the therapeutic process. <i>Methods:</i> Using data from a naturalistic study (<i>N</i> = 34) of a group-based day treatment program, we examined whether there was an interactive effect of AvPD symptoms and expressive suppression on treatment outcome. <i>Results:</i> Findings revealed a significant moderating effect of expressive suppression on the association between AvPD symptoms and treatment outcome. The outcome for patients with more severe AvPD symptoms was particularly poor when they engaged in high levels of expressive suppression. <i>Discussion:</i> The findings suggest that the combination of significant AvPD pathology and high expressive suppression is associated with poorer responsiveness to treatment.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"114-123"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9491381","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}
{"title":"From Mourning and Melancholia to Neurobiology in an Era of Global Warming, Pandemic Disease, and Social Chasms: Grief as a Requisite for Change.","authors":"Joanna E Chambers","doi":"10.1521/pdps.2023.51.1.45","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.45","url":null,"abstract":"<p><p>We find ourselves in a unique time in history with the confluence of a pandemic, global warming, and social chasms felt throughout the world. In this article, it is suggested that the grieving process is necessary for progress. The article addresses grief from a psychodynamic lens and progresses through the neurobiological changes that occur in the grieving process. The article discusses grief as both a result of and a necessary response to COVID-19, global warming, and social unrest. It is argued that grief is a vital process in order to fully change as a society and move forward. The role of psychiatry, and specifically psychodynamic psychiatry, is integral in paving the way to this new understanding and a new future.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"45-62"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506784","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}
{"title":"Abortion: Perspectives from an APA Past-President.","authors":"Nada L Stotland","doi":"10.1521/pdps.2023.51.1.1","DOIUrl":"10.1521/pdps.2023.51.1.1","url":null,"abstract":"<p><p>The United States Supreme Court's decision in <i>Dobbs v. Jackson Women's Health Organization,</i> eliminating the national right to abortion, poses challenges to psychiatrists and patients. Abortion laws now vary widely from state to state and are constantly changing and being challenged. The laws affect both patients and health care professionals; some prohibit not only the performance of abortion but efforts to inform and assist patients seeking abortion. Patients may become pregnant during and/or because of episodes of clinical depression, mania, or psychosis, and recognize that their current circumstances will not allow them to become adequate parents. Some laws allowing abortion to protect a woman's life or health explicitly exclude mental health risks; many prohibit transfer of a patient to a permissive venue. Psychiatrists working with patients contemplating abortion can convey the scientific evidence that abortion does not cause mental illness and help them identify and work through their own beliefs, values, and likely responses to the decision. Psychiatrists will also have to decide whether medical ethics or state laws will govern their own professional behavior.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506779","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}
{"title":"Reflections on Losing My Office during the Pandemic.","authors":"Elizabeth Tillinghast","doi":"10.1521/pdps.2023.51.1.21","DOIUrl":"https://doi.org/10.1521/pdps.2023.51.1.21","url":null,"abstract":"<p><p>Reflections on loss, grief, and the possibility of recovery after losing my office, my analyst's office, and my analyst during the pandemic. The role of an office in consolidating a sense of analytic identity and the usefulness of sadness in catalyzing change are discussed.</p>","PeriodicalId":38518,"journal":{"name":"Psychodynamic Psychiatry","volume":"51 1","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506780","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}