Recognizing Resistance in the Therapeutic Environment
February 1st 1997Despite the proliferation of competing psychoanalytic theories in the past three decades, for most analysts the recognition and interpretation of resistance (as well as transference) remains at the core of psychoanalytic technique. While resistance has been defined as encompassing all of a patient's defensive efforts to avoid self-knowledge (Moore and Fine), operationally it means those behaviors that help the patient ward off disturbing feelings such as anxiety, anger, disgust, depression, envy, jealousy, guilt and shame.
Guidelines for Clinicians Working with Gifted, Suicidal Adolescents
January 2nd 1997Adolescents are among the most difficult populations with whom to work therapeutically. Giovacchini (1985) wrote that they possess a "propensity for creating problems within the treatment setting [including]...their reticence about becoming engaged or their inclination to express themselves through action rather than words and feelings."
Commentary: Against Biologic Psychiatry
December 1st 1996As a practicing psychiatrist, I have watched with growing dismay and outrage the rise and triumph of the hegemony known as biologic psychiatry. Within the general field of modern psychiatry, biologism now completely dominates the discourse on the causes and treatment of mental illness, and in my view this has been a catastrophe with far-reaching effects on individual patients and the cultural psyche at large. It has occurred to me with forcible irony that psychiatry has quite literally lost its mind, and along with it the minds of the patients they are presumably supposed to care for. Even a cursory glance at any major psychiatric journal is enough to convince me that the field has gone far down the road into a kind of delusion, whose main tenets consist of a particularly pernicious biologic determinism and a pseudo-scientific understanding of human nature and mental illness.
Psychoanalytic Method and the Mischief of Freud-Bashers
December 1st 1996Psychotherapy is as old as civilization. Literally soul therapy, the term is a misnomer, since soul is a mystical notion and what is meant is the whole person. The misnomer also survives in the name psychiatry, literally soul medicine. Yet nobody is crusading against psychiatry and psychotherapy because soul is unscientific. What is important is that psychotherapy and psychiatry are job descriptions that refer to what we actually do when as providers or recipients of the service called psychotherapy, we use words to convey meaningful messages to each other, or to evoke desirable acts from each other.
NIMH Team Links Tourette's Severity with Supersensitive Receptors
November 1st 1996In 1885, Georges Gilles de la Tourette, M.D., described in the Achives of Neurology a neuropsychiatric disorder characterized by chronic motor and vocal tics that begin in childhood. During the next century, researchers demonstrated that the disorder, which came to be called Tourette's syndrome (TS), is probably inherited as a dominant gene that expresses with widely varying symptoms, even within monozygotic twin pairs.
Female Gender, Mood Disorders Are Historically Related
October 1st 1996Mood disorders and their impact on women and their families was the topic of a half-day conference held at New York City's Algonquin Hotel;, former haunt of the famous-and depressed- writer Dorothy Parker, who made at least one suicide attempt there in the early 1900s.
Delights and Dangers of the Internet
October 1st 1996"The Internet is like being in another world- you can pretend to be everything you ever wanted to be. There are no rules and no sense of time. In one hour you can tell each other all about yourselves. It's so interactive- question and answer and so quickly. No limits." Exhilaration was the expression of a 49-year-old divorced male gynecologist with the password "lady's doc."
Psychologists Sue Managed Care Company Over Termination Practices
September 1st 1996In what well may be a first in the managed behavioral health care industry, the New Jersey Psychological Association (NJPA) and seven psychologists filed a lawsuit against MCC Behavioral Care Inc. contesting the firm's utilization of "without cause" termination contract provisions. The case may break new ground in the way managed care companies interact with providers, and may question whether managed care companies can deselect providers despite the potential harm to patients.
Computer Coverage Nets Capacity Crowds
September 1st 1996September 1996, Vol. XIII, Issue 9Reflecting today's surging interest in computers and what they can do for mental health professionals, it was standing room only at many of the 19 computer-related presentations offered at the American Psychiatric Association's 149th annual meeting, more than triple the number included at last year's convention.
What's Available On-Line for Mental Health Professionals?
September 1st 1996With the exploding growth of the Internet, more and more people are going on-line. Mental health professionals are finding discussion groups filled with like-minded researchers and practitioners in every aspect of the field. Laypeople are discovering the value and enrichment that mutual self-help support groups and educational materials lend to their treatment. It is important, if not invaluable, to become familiar with this new world of opportunity and to learn about what's currently available and what's coming in future years.
Psychiatry in the New Millennium
August 1st 1996As psychiatry is swept along by the evolutionary winds of change, will you be poised and trained for success? This question was posed to psychiatrists by Joel Yager, M.D., at the recent annual meeting of the American Psychiatric Association, at which he received the Seymour D. Vestermark Award.
Rural Psychiatry's Appeal Increasing as Urban Opportunities Diminish
August 1st 1996Rural psychiatry is on the threshold of an immense transformation. Across the country, each state, faced with mandates to cut budgets and conserve health care spending, is in the complex process of negotiating the changing world of health care reimbursement and the redistribution of ever-shrinking funds. Since the majority of rural psychiatric care is delivered at community mental health centers, which rely heavily on state and federal government funding and initiatives, rural psychiatrists are likely to find themselves battling bureaucratic waves that challenge their resourcefulness and ardor.
Research Developments and Their Implications for Clinical Care of the ADHD Child
July 2nd 1996Attention-deficit/hyperactivity disorder (ADHD) has received an extraordinary amount of attention in the popular media over the past eight months. Stories concerning the disorder, and especially its treatment with stimulant medication, have appeared in many major newspapers, news magazines and television news, entertainment and talk show programs.
Therapy for Sexual Impulsivity: The Paraphilias and Paraphilia-Related Disorders
June 1st 1996Paraphilias as defined by DSM-IV, are sexual impulse disorders characterized by intensely arousing, recurrent sexual fantasies, urges and behaviors (of at least six months' duration) that are considered deviant with respect to cultural norms and that produce clinically significant distress or impairment in social, occupational or other important areas of psychosocial functioning.