How a Dream Led Me to Psychoanalysis.

This column addresses the role of dreams in psychoanalysis and psychodynamic therapy. It includes an autobiographical perspective on how a dream led this psychiatrist to become a psychoanalyst and an introduction to social dreaming.

Psychotherapy and Artificial Intelligence.

This column explores the challenges involved in providing psychotherapy through artificial intelligence. It reviews artificial intelligence's capacity across schools of therapy to address relevant issues related to privacy, the use of technical interventions, and the therapeutic relationship.

Psychodynamic Therapy: An Overview for Trainees and Their Teachers: Part 2-The Therapeutic Stance.

This second column in a series on psychodynamic therapy (PDT) offers an overview of concepts related to the therapeutic stance of PDT. It reviews resistance, components of the therapeutic relationship, and elements that constitute the therapeutic stance of PDT.

Psychodynamic Therapy: An Overview for Trainees and Their Teachers: Part 1-The Basics.

This first column in a series on psychodynamic therapy (PDT) offers an overview of the basics required to understand and master the provision of PDT. It offers a way of understanding what patients struggle with when viewed through a psychodynamic lens and then examines evidence-based core elements of psychotherapy and PDT.

Medications, Genes, Environmental Stress, and Pursuit of Recovery.

This column summarizes the findings of 2 recent studies of interest to psychotherapists. One study reports that the use of antidepressant medication is not associated with long-term improvement in health-related quality of life, while the other finds that psychotic experiences in adolescents are more closely associated with environmental experiences than with genetic risk. The column discusses the implications of these studies for psychotherapists and for the field at large.

A Verdict Overturned: Are We at Our Wit's End?

Despite the 2008 Mental Health Parity and Addiction Equity Act, access to psychotherapy through health insurance is quite limited. The 2019 landmark verdict in Wit v. United Behavioral Health offered hope of change.

Finding Psychodynamic Psychiatry's Lost Generation.

This paper describes forces that have adversely affected the place of the psychodynamic perspective within psychiatric practice and training over the last generation. One effect of these forces has been to create a lost generation of psychiatrists with little knowledge or experience with psychodynamic treatment. The article addresses opportunities to reverse some of the detrimental effects of recent changes.

Another Step Toward Implementing Mental Health Parity.

This column describes a recent $14.3 million settlement in a case brought against United Behavioral Health by the Department of Labor and New York State Attorney General Letitia James. United Behavioral Health agreed to stop 2 practices that were in violation of the Mental Health Parity and Addiction Equity Act.

Emerging Psychotherapies for Psychosis.

Recent developments in the research and clinical literatures have highlighted the importance of focusing on higher-order cognitive processes in the treatment of psychotic disorders. A particular emphasis has been placed on how impairments in self-monitoring and the ability to form mental representations of others uniquely manifest in psychosis. At the same time, the recovery movement has influenced clinical innovations by emphasizing the importance of subjective domains of recovery that privilege the individual's phenomenological experience.

A view from Riggs: treatment resistance and patient authority--X: from acting out to enactment in treatment resistant disorders.

Abstract Patients with treatment resistant disorders pose a major problem to clinicians of all theoretical perspectives, including psychodynamic therapists. Treatment of such patients often results in stalemates and impasses, and acting out is a frequent phenomenon. This paper addresses the value in work with such patients of looking beyond the concept of acting out, which is a one-person definition of a problem, toward the concept of enactment, which recognizes the roles both therapist and patient play in the phenomenon of treatment resistance.

A view from Riggs--treatment resistance and patient authority: I. A psychodynamic perspective on treatment resistance.

Treatment resistance has emerged as a significant issue in our era emphasizing biological treatments for psychiatric disorders. This article suggests that, particularly when Axis II disorders are part of the clinical presentation, a subset of treatment refractory patients responds to a psychodynamic treatment approach that includes careful attention to the meaning of treatment resistance, and to the importance of relationships and of patient authority in recovery. The importance of engaging the negative transference and countertransference in treatment is also emphasized.