Overview
The troubling increase in treatment resistance in psychiatry has many culprits: the rise of biomedical psychiatry and corresponding sidelining of psychodynamic and psychosocial factors; the increased emphasis on treating the symptoms rather than the person; and a greater focus on the electronic medical record rather than the patient, all of which point to a breakdown in the person-centered prescriber–patient relationship. Psychodynamic Psychopharmacology illuminates a new path forward. It examines the psychological and interpersonal mechanisms of pharmacological treatment resistance, integrating research on evidence-based prescribing processes with psychodynamic insights and skills to enhance treatment outcomes for patients who are difficult to treat. The first part of the book explores the evidence base that guides how, rather than simply what, to prescribe. It describes precisely what psychodynamic psychopharmacology is and why its emphasis on combining the often-neglected psychosocial aspects of medication with biomedical considerations provides a more optimized approach to addressing treatment resistance. Part II delves into the psychodynamics that contribute to pharmacological treatment resistance, both when patients' ambivalence about their illness, the medication itself, or their prescriber manifests in nonadherence and when medications support a negative identity or are used as replacements for healthy capacities. Readers will gain basic skills for addressing the psychological and interpersonal dynamics that underpin both scenarios and will be better positioned to ameliorate interferences with the healthy use of medications. The final section of the book offers detailed technical recommendations for addressing pharmacological treatment resistance. It tackles issues that include countertransference-driven irrational prescribing; primitive dynamics, such as splitting and projective identification; and the overlap between psychopharmacological treatment resistance and the dynamics of treatment nonadherence and nonresponse in integrated and collaborative medical care settings. By putting the individual patient back at the center of the therapeutic equation, psychodynamic psychopharmacology, as outlined in this book, offers a model that moves beyond compliance and emphasizes instead the alliance between patient and prescriber. In doing so, it empowers patients to become more active contributors in their own recovery.
Full Product Details
Author: David Mintz
Publisher: American Psychiatric Association Publishing
Imprint: American Psychiatric Association Publishing
Weight: 0.408kg
ISBN: 9781615371525
ISBN 10: 1615371524
Pages: 295
Publication Date: 11 April 2022
Audience:
Professional and scholarly
,
Professional & Vocational
Format: Paperback
Publisher's Status: Active
Availability: Manufactured on demand
We will order this item for you from a manufactured on demand supplier.
Reviews
This book is the first of its kind in providing a comprehensive review of psychodynamic psychopharmacology. While a few book chapters or editorials have been powerful, this book offers a potent mix of research reviews, clinical examples, vignettes, practical tips, and effective use of tables and graphs. The author articulates the impact of the therapeutic relationship on psychopharmacologic interventions and how to manage common clinical pitfalls. -- Daniel M Tuinstra, MD * Doody * David Mintz's book on psychodynamic psychopharmacology invites us to consider how rather than what to prescribe. Echoing Balint, he reminds us that the pharmacotherapeutic alliance and the manner in which the doctor interacts with the patient are instrumental to outcomes. He educates us on factors that affect treatment, such as patient characteristics (attachment style, placebo, treatment preference) and prescriber characteristics (warmth, promoting autonomy, supporting decision-making).The book is well structured, starting with defining psychodynamic psychopharmacology and its large evidence base. It provides a framework for considering treatment resistance at the level of meaning and subsequently breaks down the overarching principles of psychodynamic psychopharmacology. It is suffused with case formulations and transcripts of conversations with patients. We meet a patient whose psychosis was protecting them against the depressing reality of an earlier loss; the prescriber took this into account when deciding to prescribe less aggressively and to allow for grieving to take place. Examples of patients using their medication in countertherapeutic ways or being unhealthily attached to their tablets made me consider my own practice. Prescribing in a truly integrated way can feel like a novelty and sometimes lonely in a predominantly biological psychiatric paradigm. You are not alone. Mintz guides you with a manual on how to approach the engagement and maintenance phase of prescribing. There is a self-assessment toolkit and a glossary, all invaluable tools for clinical practice and teaching purposes. This book does not antagonise but it complements the science of psychopharmacology. It should be in the curriculum of psychiatric if not medical training. It is likely to restore faith in psychiatry as a profession and in our roles as doctors of the mind and the body. * British Journal of Psychiatry *
Author Information
David Mintz, M.D., is Director of Psychiatric Education, Associate Director of Training, and a Team Leader at the Austen Riggs Center in Stockbridge, Massachusetts.
