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The Use of Imagery in Alleviating Depression
Published in Anees A. Sheikh, Imagination and Healing, 2019
Dynamic, Insight-Oriented Psychotherapy. This therapy offers a more moderate alternative to both brief supportive psychotherapy and intensive psychoanalytic treatment. Like psychoanalysis, it usually involves the exploration of complex historical patterns of behavior stemming from early life experiences and it emphasizes the usefulness of insight to improvement. While there is considerable controversy regarding the efficacy of insight and the usefulness of traditional psychotherapy regardless of orientation, the fact that most traditional dynamic psychotherapies are limited to those who are wealthy, intelligent, relatively stable, and able to tolerate considerable frustration for extended periods of time lead many clinicians to explore other types of psychotherapeutic treatment for patients suffering from depression as well as other psychiatric disorders.
The psychodynamic ego
Published in Allan Hobson, Psychodynamic Neurology, 2014
In both cases the overprotection that is offered by the caretaker or parent relieves that person of the guilt of absentee negligence at the same time that it secures even tighter parental control. Hypochondriacal and obsessive persons are both incapacitated by their controlling master parents. It may be true that insight-oriented psychotherapy is very good at establishing such hypotheses. But uncovering family dynamics, however accurately, explains but does not reverse the symptom. The psychoanalytic shibboleth that such symptoms can be dissolved by regression and transference analysis has never been subjected to rigorous test, and such uncertain treatment is both lengthy and costly.
Anxiety Disorders
Published in David F. O'Connell, Dual Disorders, 2014
Patients should be informed about the potentiating effects of caffeine. A strong cup of coffee may predispose a panic-disordered patient to an attack. Decaffeinated coffee or herbal teas should be substituted. Panic-disordered patients can benefit from engaging in relaxation therapy, and time should be allotted in their day so that they can do so comfortably. This may be progressive relaxation, autogenic training, imagery, meditation, regular repetitive exercise such as running, swimming, or some other activity. Aftercare is important for panic-disordered patients. They should be routinely referred to a mental health professional for treatment and ongoing monitoring of their disorder. For some panic-disordered patients, insight-oriented psychotherapy may be helpful in dealing with the psychological aspects of the disorder. Behavioral therapy, biofeed-back-assisted relaxation, and hypnosis are among the many techniques psychologists employ to treat panic disorder, and some addicts with panic disorder can benefit from them.
An Inpatient Psychiatric Service Use of the Live Case Conference
Published in Psychiatry, 2020
Dr. Selzer has given us a well-conceived account of how we, the profession of psychiatry, organized at one time in our history our approach to patient care, both in supervising/teaching as well as documenting patient experience, in a detailed manner. Which leads to the suggestion of a new title, the Role and Value of the Case Conference: Some Neglected Aspects. The truth is that we still have not completely settled how we conceptualize and deal with organizing resources to guarantee that all patients, even the most impaired, get the best care possible. The case conference is a setting where much can be worked out such as techniques, strategies, medications, plans for discharge (or not), and the treatment approaches, including goals of care and the identification of areas of interest in which all staff may not be familiar, i.e., the educational mission. The case conference not only addresses the education of the trainees (and the staff for that matter) but also gives the clinical staff a chance to air grievances and interact with senior leadership and to learn as well. As an aside, I must say that case conferences, in my experience, have morphed considerably from the time that I was a trainee in the mid to late 1970s. In those days the intellectual discipline of the field was struggling between and among biological approaches (medications and ECT), rehabilitative approaches such as different forms of supportive, and insight-oriented psychotherapy (psychoanalytic informed psychotherapy, cognitive and behavior therapy and supportive psychotherapy). Most of those struggles still insert themselves into a modern discourse but it does seem that we are making some progress about what works/does not work for whom.
The story of Lucy: lessons learned, lessons taught
Published in Smith College Studies in Social Work, 2018
Lucy’s long-term therapy could best be described as supportive. It is an approach to therapy that we hear of less these days, despite the fact, as the Harvard Mental Health Letter (2004) wrote, “Supportive therapy is sometimes said to be a name for what every good psychotherapist does most of the time, often without acknowledging it and without knowing how it is done” (p. 1). Indeed, supportive psychotherapy has been around a long time, having emerged in mid twenty century (Sjoqvist, 2007), and refined in the latter decades (Pinsker, 1997; Rockland, 1992; Werman, 1984). It was conceptualized to treat people very much like Lucy. Such clients were found not suitable to insight-oriented psychotherapy that was anxiety producing and offered little in the way of emotional gratification. Consequently, supportive therapy focussed on the here-and-now, conscious thought, adaptive coping, affect regulation, problem solving, and for the most part supported rather than interpreted defenses (Rockland, 1992). Unfortunately, although supportive psychotherapy emerged as an appropriate intervention for individuals with poor ego strength, it was devalued as a treatment when contrasted with the so-called “gold standard” of psychoanalysis (Berlincioni & Barbieri, 2004). Sadly, Gabbard (1996) observed that, “One of the ironies of our profession is that supportive therapy is probably the most commonly practiced therapeutic modality in the field, but it receives much less emphasis in training programs than its expressive counterpart” (p., 316). And, with particular import to this case report, Gabbard adds that, “… boundaries and attention to countertransference may be even more important in supportive therapy than in exploratory therapy” (p. 316). In reference to Lucy, safety in this therapeutic relationship was earned as a consequence of establishing and maintaining boundaries overtime over a lengthy period of time. Such boundaries included keeping the same appointment time, starting and ending sessions on time, limiting phone calls, and judicious use of self-disclosure.
Kleptomania as a neglected disorder in psychiatry
Published in International Review of Psychiatry, 2020
Julio Torales, Israel González, João Mauricio Castaldelli-Maia, Antonio Ventriglio
Psychoanalysis, insight-oriented psychotherapy, and behavioural therapy have been tried in the treatment of these patients. There is very little evidence, however, to guide the selection of one approach over another in the treatment of this disorder (Grant, 2006).