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Psychodynamic Psychopharmacology - Caring for the Treatment-Resistant Patient (Paperback)
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Psychodynamic Psychopharmacology - Caring for the Treatment-Resistant Patient (Paperback)
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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.
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