Treatment resistance in psychiatry is increasing and needs to be addressed. While the causes are manifold and complex, they include: a focus on individual biology to the exclusion of more nuanced psychosocial factors, treating symptoms first instead of the person, and letting electronic medical records and insurance drive decision-making. All of this leads to worse care and poorer outcomes for our patients who we are all doing our best to help.
The good news is there is a way forward that reclaims the person-centered prescriber-patient relationship that should be the hallmark of good psychiatric care. In his new book Psychodynamic Psychopharmacology (2022, American Psychiatric Association Publishing), Austen Riggs Center Director of Psychiatric Education David Mintz, MD, outlines this new approach to help understand the issues at hand and solve the problem of pharmacological treatment resistance to improve care and outcomes for patients who have been labeled “difficult to treat.”
Organized into three sections, Psychodynamic Psychopharmacology
can change the way you practice and become an indispensable resource for virtually any psychiatric practice setting or training program.
Part 1. What Is Psychodynamic Psychopharmacology?
- Explains what psychodynamic psychopharmacology is
- Describes how (rather than what) to prescribe
- Advocates for combining psychosocial and biomedical aspects
Part 2. Understanding Pharmacological Treatment Resistance
- Explores the dynamics that contribute to pharmacological treatment resistance
- Details basic skills for addressing the psychological and interpersonal dynamics
- Illustrates how these skills help prescribers assist patients in the healthy use of medications
Part 3. The Manual of Psychodynamic Psychopharmacology
- Provides a detailed manual with technical recommendations for addressing treatment resistance
- Tackles issues including
- Countertransference-driven irrational prescribing
- Primitive dynamics, such as splitting and projective identification
- Overlap between psychopharmacological treatment resistance and the dynamics of treatment nonadherence and nonresponse in integrated and collaborative medical care settings
This book is a call to action for psychiatrists to put their patients back at the center of treatment with an evidence-based roadmap to achieve success. With the alliance between patient and prescriber front and center, there is a true opportunity to empower patients to become more active agents in their treatment and help psychiatrists refocus their expertise to provide excellent, truly individualized care.