Elective in Psychodynamic Psychiatry

The Elective in Psychodynamic Psychiatry is designed to provide students of psychiatry (including both medical students and psychiatric residents) with a perspective that complements the medical model that is dominant in mainstream psychiatric approaches to major psychiatric illness. Students join the Therapeutic Community in a psychoanalytic hospital. In this context, students have an opportunity to learn how a patient-centered, psychodynamically-informed approach is able to capitalize on issues of meaning, relationships, and patient authority in order to optimize treatment outcomes for patients who have typically been seen as treatment-resistant.  

The elective is intended to provide students with an understanding of how developmental issues and maladaptive efforts to cope with developmental stress can foster psychopathology.  Students learn how psychodynamics affect not only individual psychology, but also shape group functioning (including the function of clinical treatment teams), medication responsiveness, and other aspects of psychiatric practice. By attending staff and team meetings, case conferences, individual supervision, and other educational opportunities, students learn about the psychotherapeutic role, deepen their understanding of the importance of psychotherapeutic boundaries, and understand more about the struggles and techniques involved in attaining a therapeutic alliance.  Didactic experiences complement this learning and help students develop a deeper understanding of psychoanalytic theory.

The learning experience may be tailored to the specific interests of more advanced students and residents, including a broader focus on learning about psychodynamic approaches to treatment-resistance or the psychodynamics of groups and therapeutic community treatment. Residents will also conduct interviews with patients aimed at developing a usable psychodynamic formulation that appreciates the adaptive value of the patient’s psychopathology, transference and countertransference implications emerging from the patient’s history, and an appreciation of how the patient’s dynamics contribute to treatment-resistance, including resistance in relation to pharmacotherapy.

The varied educational experience at Riggs typically includes:

  • involvement in the therapeutic community program as participant observers
  • learning about psychotherapy and dynamic formulation
  • learning about the psychodynamics of psychopharmacology
  • a focus on patient’s strengths
  • didactic experiences
  • integration of the entire learning experience through supervision/mentorship by therapy staff.

At the conclusion of the elective, students are expected to:

  • demonstrate a basic understanding of the process of psychodynamic psychotherapy 
  • demonstrate a general grasp of psychoanalytic concepts
  • express a basic knowledge of transference and countertransference
  • demonstrate a clear understanding of the importance of boundaries in psychiatry  
  • convey an understanding of the fundamental principles of psychodynamic psychopharmacology

Students eligible for this rotation will have already completed a core clinical rotation in psychiatry and be in good standing in their training programs. Interested students should complete and submit the online application along with the requested documentation to the elective’s administrator, Kathleen Young, at kathleen.young@austenriggs.net or by mail. For additional information about the elective, medical students should and psychiatric residents should contact David Mintz, MD, at david.mintz@austenriggs.net or 413.931.5315.

"I found the need to trust myself, and to trust those around me. . . . If there is anything I could hope for, it's for the Riggs community to continue to build an environment of trust, relationship, and connection with each other. To feel a common bond and connection is an underpinning of any therapeutic relationship, including a therapeutic community."  
– Ram Lakhani, former Elective in Psychodynamic Psychiatry student 

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