The Riggs Difference: Where Understanding Leads to Recovery
David Mintz, MD, is interviewed by Awais Aftab, MD, for the Psychiatry at the Margins piece "Meaning, Medications, and Psychodynamic Psychopharmacology: Discussion with David Mintz."
(from the publisher)
"David Mintz is a master of applying psychodynamic thinking to the practice of psychopharmacology. He does it with unparalleled elegance and sophistication. I can chart the evolution of my own thinking of psychopharmacology in terms of Before Mintz and After Mintz! His core message is that the effects of psychiatric medications are produced, in part, through people and relationships and the meanings patients attach to illness and pills. Psychodynamic psychopharmacology builds on six principles: avoid mind–body splits, know who the patient is, work with ambivalence, cultivate the alliance, watch for countertherapeutic uses of meds, and use countertransference wisely. Mintz reframes “treatment resistance” in two ways: resistance to medication (nonadherence, nocebo-driven side effects) and resistance from medication (when drugs or their meanings quietly maintain problems resulting in chronification). Because many patients receive care from multiple clinicians, Mintz insists on integration of pharmacological and psychotherapeutic treatment; split vs. combined care vis-à-vis psychiatrist vs. psychotherapist is less important than whether everyone shares a coherent, person-centered treatment conceptualization aimed at restoring agency and functioning."