Psychodyn Psychiatry
January 2025
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.
View Article and Find Full Text PDFAccording to psychoanalysis, anxiety signals a threat whenever a forbidden feeling emerges. Anxiety triggers defenses and maladaptive behaviors, thus leading to clinical problems. For these reasons, anxiety regulation is a core aspect of psychodynamic-oriented treatments to help clients.
View Article and Find Full Text PDFThe aim of this article is to present recent applications of emotion regulation theory and methods to the field of psychotherapy. The term Emotion Regulation refers to the neurocognitive mechanisms by which we regulate the onset, strength, and the eventual expression of our emotions. Deficits in the regulation of emotions have been linked to most, if not all, psychiatric disorders, with patients presenting either dysregulated emotions, or dysfunctional regulatory strategies.
View Article and Find Full Text PDFAddiction programs are plagued with high dropout and relapse rates. A large proportion of patients suffering from addiction also suffer from personality disorders. A 30-day inpatient program based on intensive short-term dynamic psychotherapy was developed to address features of personality disorders such as anxiety regulation, emotion recognition, and handling of fear responses and projective processes.
View Article and Find Full Text PDFDespite the traditional view of Schizophrenia (SZ) and Bipolar disorder (BD) as separate diagnostic categories, the validity of such a categorical approach is challenging. In recent years, the hypothesis of a continuum between Schizophrenia (SZ) and Bipolar disorder (BD), postulating a common pathophysiologic mechanism, has been proposed. Although appealing, this unifying hypothesis may be too simplistic when looking at cognitive and affective differences these patients display.
View Article and Find Full Text PDFOne of the main objectives of psychotherapy is to address emotion dysregulation that causes pathological symptoms and distress in patients. Following psychodynamic theory, we propose that in humans, the combination of emotions plus conditioned anxiety due to traumatic attachment can lead to dysregulated affects. Likewise, defenses can generate and maintain dysregulated affects (altogether Dysregulated Affective States, DAS).
View Article and Find Full Text PDF: Social cognition is commonly affected in psychiatric disorders and is a determinant of quality of life. However, there are few studies of treatment.: To investigate the efficacy of intensive short-term dynamic psychotherapy on social cognition in major depression.
View Article and Find Full Text PDFGervais & Fessler argue that contempt is an attitude state defined as a lack of respect that potentiates the activation and deactivation of two different clusters of emotions. However, clinical and experimental findings do not support this view. We provide evidence that contempt is not an emotion, nor an attitude, but a reactive defensive mechanism evolved to help individuals avoid shame.
View Article and Find Full Text PDFClinical supervision and training are now widely available online. In this article, three of the most accessible and widely adopted new developments in clinical supervision and training technology are described: Videoconference supervision, cloud-based file sharing software, and clinical outcome tracking software. Partial transcripts from two online supervision sessions are provided as examples of videoconference-based supervision.
View Article and Find Full Text PDFPsychotherapy supervision and training are now widely available online. However, many supervisors still may be unclear on how online supervision actually works, or what it actually looks like in practice. In this article, three case examples of online videoconference-based supervision programs will be described.
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