Psychotherapy

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About a year ago, I wrote the blog “Are Dogs Man's Best Therapist?” To my surprise, it turned out to be a very popular one. Since then, dogs continue to be in the news for their therapeutic effect, including being brought to Newtown right after the mass murder there.

Knowing from the start how a personality is organized, especially as theorized by Karen Horney-appreciating the primary and repressed moves of the patient, inner dictates, claims, idealized image, and intrapsychic defensive maneuvers-makes the help we offer most likely to succeed.

For prescribing psychiatrists who want to offer treatment alternatives to patients who prefer to avoid medication, the evidence is clear that psychotherapy is an effective choice. Even in cases in which medication is accepted, the evidence suggests that psychotherapy may significantly improve patient outcomes.

A therapist forgets about a patient’s appointment. She becomes abnormally angry, unusually forgiving, atypically bored, or excessively voyeuristic. What is going on? The therapist’s countertransference is making itself known.

Psychotherapy outcomes and the mechanisms of change that are related to its effects have traditionally been investigated on the psychological and social levels, by measuring changes in symptoms, psychological abilities, personality, or social functioning.

Treatment resistance in bipolar disorder is clinically familiar but lacks a standard definition. Numerous evidence-based treatments exist for all phases of bipolar disorder, and these should be optimized and fully explored.

Many psychiatrists, residents, and other mental health professionals believe that psychodynamic therapy lacks empirical support or that other psychotherapies are more effective.

There is currently a small but impressive evidence base that shows that psychological and interpersonal factors play a pivotal role in pharmacological treatment responsiveness.

Although several studies indicate that psychotherapy (alone or in combination with medications) can help psychiatric patients reach recovery faster and stay well longer, a declining number of office-based psychiatrists are providing psychotherapy to their patients.