Psychodynamic Psychopharmacology: Technical Principles
Over the past several decades, mental health care has been transformed by the advent of safer, more tolerable, and, perhaps, more effective medications. There is, however, little evidence that this had led to substantially better outcomes. Treatment resistant psychiatric conditions are still too frequently the rule rather than the exception.
In those cases where patients respond to medications, it is likely that the meanings that a medication holds for a patient are concordant with their intended effect. In those cases where patients are unable to benefit from pharmacologic treatment, it is often the case that medications bear meanings, often unconsciously, that are antithetical to their intended effect. When treatment resistance emerges in this way from the level of meaning, it is likely that it can only be effectively addressed at the level of meaning.
Considering the evidence base demonstrating that the psychosocial factors profoundly shape medication outcomes, this presentation will look at ways to integrate this information into integrated behavioral health treatments. We will look at some of the impediments to integrating biological, psychological, and social aspects of treatment. We will address specific technical problems of integration, including transcending a mind-body split in treatment approaches, understanding meaning factors associated with medications, forging a treatment alliance based on those understandings, and identifying and reducing treaters’ contributions to pharmacologic treatment resistance. The presentation will also explore the ways that an exploration of the meaning of medications can deepen therapies and add to patients’ self-understanding in important ways.
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