Splitting, archetypally imbedded in a patient's psychic structure, acts as a powerful unconscious force to protect against the ego's perception of dangerous anxiety and intense affects. Rather than providing real protection, splitting leads to destructive behavior and turmoil in patients' lives.

Borderline Personality Disorder: Splitting Countertransference

This month establishes a milestone for CME LLC Not only is it the company's 11th annual U.S. Psychiatric & Mental Health Congress, it also marks the 20th anniversary of the company's first conference. CME LLC grew out of a desire to reach and educate more people regarding psychiatric issues. One way to do this was by developing high-quality continuing education opportunities.

Growth, Changes Mark CME LLC's 20-Year Anniversary

Apology

The Health Care Financing Administration (HCFA), the agency responsible for administering the burgeoning Medicare program for the elderly, announced a nationwide crackdown on community mental health care centers (CMHCs) in September, signaling increased efforts to curtail fraud, error and abuse.

Rampant Fraud and Abuse of Medicare Funds Alleged at Community Mental Health Care Centers

The dynamically informed psychotherapies can be thought to occur on a continuum, with the most insight-oriented and exploratory types at one end and the most supportive types at the other. Psychoanalysis proper stands at the end of this continuum, followed by analytically oriented psychotherapy, then dynamically oriented psychotherapy. Within this classification, analytical oriented psychotherapy and dynamic oriented psychotherapy are two quite distinct, yet related, forms of therapy.

Analytic vs. Dynamic Psychotherapy  in the Era of Managed Care

Organ donation from brain-dead patients has become a psychiatric issue in Japanese transplant medicine. Brain death is recognized as human death only in the context of organ transplantation in Japan. Since many Japanese physicians deny that brain death constitutes the death of an individual, there is no solid, general consensus in Japan about what constitutes brain death.

A New Screening Measure for Detecting 'Hidden'  Domestic Violence

The poet must remember that it is his poetry which bears the guilt for the vulgar prose of life, whereas the man of everyday life ought to know that the fruitlessness of art is due to his willingness to be unexacting and to the unseriousness of the concerns to his life. The individual must be answerable through and through: all of his constituent moments must not only fit next to each other in the temporal sequence of his life, but must also interpenetrate each other in the unity of guilt and answerability-M.M. Bakhtin, 1919

Case Study Writing in Today's Psychiatry

An investigational compound that blocks the neurokinin "substance P" has demonstrated robust antidepressant effect in preliminary clinical testing against paroxetine (Paxil) and placebo. This finding has been described by as "a breakthrough discovery" in mental health care.

'Substance P' Antagonist Relieves Depression

Only in recent years has the widening scope of domestic violence achieved such national prominence. Highly publicized cases like the Nicole Brown Simpson murder have brought the issue of domestic violence to worldwide attention. Overall rates of violence against women, including both lethal and nonlethal violence, are much higher.

Psychotherapy as a sole treatment for noncoerced opioid addicts in outpatient settings has been shown to have little patient interest and low chances for success. However, when integrated into a treatment plan that includes methadone maintenance and drug counseling, it can be associated with additional benefits for patients who have moderate to severe levels of psychiatric symptoms.

Psychotherapy with Opioid-Dependent Patients

In view of the fact that support is an important aspect of all models of psychotherapy, it is remarkable that beginning practitioners are not taught how to be supportive. Only limited attention has been paid to discussion of the principles underlying supportive interactions. It seems to be taken for granted that good sense, kindness, innate empathy and life experience will enable psychotherapists-and physicians in general-to meet their patients' needs for support by communicating interest, liking and understanding. Just as the literature on psychoanalysis is a source for much of what we know about the expressive component of therapy, the limited literature on supportive psychotherapy is a source for ideas pertinent to the supportive component.

The Supportive Component of Psychotherapy

A popular slang definition of the verb to split is "to depart," or "to leave." In this context, to split describes the occasional wish of a psychiatrist who may be mired in the chaos created by the behavior of a patient diagnosed with borderline personality disorder. The primary definition of to split is "to divide sharply or cleanly."

Dissociative identity disorder (DID), known as multiple personality disorder until renamed in the DSM-IV (American Psychiatric Association, 1994), is a controversial diagnosis.

Psychiatric Times Vol 15 No 11