0
0

Chapter 30. Psychodynamic Psychotherapy

Robert Ursano, M.D.; Russell Carr, M.D
DOI: 10.1176/appi.books.9781585625031.120056

Sections

Excerpt

Beginning therapists often do not have the extensive psychoanalytic background that was more typical in previous years. They have limited opportunity during training to learn a particular psychotherapy, such as psychodynamic therapy, in detail. Yet, as clinicians, they may want to understand and use psychodynamic psychotherapy as a part of their therapeutic armamentarium and also use psychodynamic techniques in the evaluation and treatment of patients for whom a full psychotherapy may not be appropriate or possible.

Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Anchor for Jump
Psychodynamic psychotherapy
Anchor for Jump
Psychodynamic listening
Anchor for Jump
Psychodynamic perspectives
Anchor for Jump
Guidelines for psychodynamic assessment
Anchor for Jump
The evaluation
Anchor for Jump
Helpful hints for the evaluation
Anchor for Jump
First session
Anchor for Jump
Transference
Anchor for Jump
Defense mechanisms
Anchor for Jump
Definitions of common defense mechanisms
Anchor for Jump
Countertransference
Anchor for Jump
Criteria for termination
Anchor for Jump
Tasks of the termination phase

References

Alexander F: The voice of the intellect is soft. Psychoanal Rev 28:12–29, 1941
 
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Washington, DC, American Psychiatric Association, 2013
 
Bender DS: The therapeutic alliance in the treatment of personality disorders. J Psychiatr Pract 11:73–87, 2005
[PubMed]
 
Blatt S, Shahar G: Psychoanalysis—with whom, for what, and how? Comparisons with psychotherapy. J Am Psychoanal Assoc 52:393–447, 2004
[PubMed]
 
Blatt S, Quinlan D, Pilkonis P, et al: Impact of perfectionism and need for approval on the brief treatment of depression: the National Institute of Mental Health Treatment of Depression Collaborative Research Program revisited. J Consult Clin Psychol 63:125–132, 1995
[PubMed]
 
Bond M: Psychodynamic psychotherapy in the treatment of mood disorders. Curr Opin Psychiatry 19:40–43, 2006
[PubMed]
 
Bond M, Perry C: Long-term changes in defense styles with psychodynamic psychotherapy for depressive, anxiety and personality disorders. Am J Psychiatry 161:1665–1671, 2004
[PubMed]
 
Brenner C: Psychoanalytic Technique and Psychic Conflicts. New York, International Universities Press, 1976
 
Bruch H: Learning Psychotherapy: Rationale and Ground Rules. Cambridge, MA, Harvard University Press, 1974
 
Buchheim A, Viviani R, Kessler H, et al: Changes in prefrontal-limbic function in major depression after 15 months of long-term psychotherapy. PLoS One 7:e33745, 2012
[PubMed]
 
Chessick RD: Psychoanalysis: clinical and theoretical. Am J Psychiatry 157:846–848, 2000
[PubMed]
 
Clarkin JF, Foelsch PA, Levy KN, et al: The development of psychodynamic treatment for patients with borderline personality disorder: a preliminary study of behavioral change. J Pers Disord 15:487–495, 2001
[PubMed]
 
Coleman JV: Aims and conduct of psychotherapy. Arch Gen Psychiatry 18:1–6, 1968
[PubMed]
 
Curtis HC: The concept of therapeutic alliance: implications for the “widening scope.”J Am Psychoanal Assoc 27(suppl):159–192, 1979
[PubMed]
 
Dewald PA: The clinical importance of the termination phase. Psychoanalytic Inquiry 2:441–461, 1982
[PubMed]
 
DiMascio A, Weissman M, Prusoff B, et al: Differential symptom reduction by drugs and psychotherapy in acute depression. Arch Gen Psychiatry 36:1450–1456, 1979
[PubMed]
 
Edelson M: Telling and enacting stories in psychoanalysis and psychodynamic psychotherapy. Psychoanal Study Child 48:293–325, 1993
[PubMed]
 
Etkin A, Pittenger C, Polan HJ, et al: Toward a neurobiology of psychotherapy: basic research and clinical applications. J Neuropsychiatry Clin Neurosci 17:145–158, 2005
[PubMed]
 
Fawzy F, Kemeny M, Fawzy N, et al: A structured psychiatric intervention for cancer patients, II: changes over time in immunological measures. Arch Gen Psychiatry 47:729–735, 1990
[PubMed]
 
Fawzy F, Fawzy N, Hyun C, et al: Malignant melanoma. Arch Gen Psychiatry 50:681–689, 1993
[PubMed]
 
Fonagy P, Roth A, Higgitt A: Psychodynamic psychotherapies: evidence-based practice and clinical wisdom. Bull Menninger Clin 69:1–58, 2005
[PubMed]
 
Fosshage J: The organizing function of dream mentation. Contemp Psychoanal 33:429–458, 1997
[PubMed]
 
Freud A: The Ego and the Mechanisms of Defense, Revised Edition. New York, International Universities Press, 1966
 
Freud S: The interpretation of dreams (1900), in The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vols 4 and 5. Translated and edited by Strachey J. London, Hogarth, 1953
 
Freud S: The dynamics of transference (1912), in The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol 12. Translated and edited by Strachey J. London, Hogarth, 1958, pp 97–108
 
Freud S: Resistance and repression (1917), in The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol 16. Translated and edited by Strachey J. London, Hogarth, 1963, pp 286–302
 
Fromm-Reichmann F: Principles of Intensive Psychotherapy. Chicago, IL, University of Chicago Press, 1950
 
Gabbard GO: Countertransference: the emerging common ground. Int J Psychoanal 76:475–485, 1995
[PubMed]
 
Gabbard GO: Psychodynamic Psychiatry in Clinical Practice, 4th Edition. Washington, DC, American Psychiatric Publishing, 2005
 
Gabbard GO: Techniques of psychodynamic psychotherapy, in Textbook of Psychotherapeutic Treatments. Edited by Gabbard GO. Washington, DC, American Psychiatric Publishing, 2009, pp 43–69
 
Gabbard GO: Long-Term Psychodynamic Psychotherapy: A Basic Text, 2nd Edition. Washington, DC, American Psychiatric Publishing, 2010
 
Gabbard GO, Wilkinson SM: Management of Countertransference With Borderline Patients. Washington, DC, American Psychiatric Press, 2001
 
Gabbard GO, Gunderson JG, Fonagy P: The place of psychoanalytic treatments within psychiatry. Arch Gen Psychiatry 59:505–510, 2002
[PubMed]
 
Gerber AJ: Commentary: Neurobiology of psychotherapy—state of the art and future directions, in Psychodynamic Psychotherapy Research: Evidence-Based Practice and Practice-Based Evidence. Edited by Levy RA, Ablon JS, Kachele H. New York, Humana Press, 2012, pp 187–192
 
Goldstein WN, Goldberg ST: The Transference in Psychotherapy. Northvale, NJ, Jason Aronson, 2003
 
Greenson RR: The working alliance and the transference neurosis. Psychoanal Q 34:155–181, 1965
[PubMed]
 
Guthrie E, Moorey J, Margison F, et al: Cost effectiveness of brief psychodynamic-interpersonal therapy in high utilizers of psychiatric services. Arch Gen Psychiatry 56:519–526, 1999
[PubMed]
 
Hall J, Caleo S, Stevenson J, et al: An economic analysis of psychotherapy for borderline personality disorder patients. J Ment Health Policy Econ 4:3–8, 2001
[PubMed]
 
Hofer MA: Relationships as regulators: psychobiological perspective on bereavement. Psychosom Med 46:183–197, 1984
[PubMed]
 
Horowitz MJ, Eells T, Singer J, et al: Role-relation-ship models for case formulation. Arch Gen Psychiatry 52:625–633, 1995
[PubMed]
 
House JS, Landis KR, Umberson D: Social relationships and health. Science 241:540–545, 1988
[PubMed]
 
Huttenlocher PR: Neural Plasticity. Cambridge, MA, Harvard University Press, 2002
 
Kandel ER: Biology and the future of psychoanalysis: a new framework for psychiatry revisited. Am J Psychiatry 156:505–524, 1999
[PubMed]
 
Kay J: Combining psychodynamic psychotherapy with medication, in Textbook of Psychotherapeutic Treatments. Edited by Gabbard GO. Washington, DC, American Psychiatry Publishing, 2009, pp 133–165
 
Kernberg OF: Borderline Conditions and Pathological Narcissism. New York, Jason Aronson, 1975
 
Kernberg OF: Transference and countertransference in the treatment of borderline patients, in Object-Relations Theory and Clinical Psychoanalysis. New York, Jason Aronson, 1976, pp 161–184
 
Klerman GL, DiMascio A, Weissman MM, et al: Treatment of depression by drugs and psychotherapy. Am J Psychiatry 131:186–191, 1974
[PubMed]
 
Lazar SG (ed): Extended dynamic psychotherapy: making the case in an era of managed care. Psychoanalytic Inquiry (suppl):1–110, 1997
[PubMed]
 
Lazare A, Eisenthal S: Clinician/patient relations, I: attending to the patient’s perspective, in Outpatient Psychiatry. Edited by Lazare A. Baltimore, MD, Williams & Wilkins, 1989a, pp 125–136
 
Lazare A, Eisenthal S, Frank A: Clinician/patient relations, II: conflict and negotiation, in Outpatient Psychiatry. Edited by Lazare A. Baltimore, MD, Williams & Wilkins, 1989b, pp 137–157
 
Leichsenring F: Are psychodynamic and psychoanalytic therapies effective? A review of empirical data. Int J Psychoanal 86:841–868, 2005
[PubMed]
 
Leichsenring F, Leibing E: The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: a meta-analysis. Am J Psychiatry 160:1223–1232, 2003
[PubMed]
 
Leichsenring F, Rabung S: Effectiveness of long-term psychodynamic psychotherapy: a meta-analysis. JAMA 300:1551–1565, 2008
[PubMed]
 
Levinson D, Merrifield J, Berg K: Becoming a patient. Arch Gen Psychiatry 17:385–406, 1967
[PubMed]
 
Loewald HW: On the therapeutic action of psycho-analysis. Int J Psychoanal 41:16–33, 1960
[PubMed]
 
Luborsky L, Crits-Christoph P: Understanding Transference: The CCRT Method, 2nd Edition. Washington, DC, American Psychological Association, 1998
 
MacKinnon RA, Michels R, Buckley PJ (eds): The Psychiatric Interview in Clinical Practice, 2nd Edition. Washington, DC, American Psychiatric Publishing, 2006
 
Malan D: Individual Psychotherapy and the Science of Psychodynamics, 2nd Edition. Oxford, UK, Butterworth-Heinemann, 1999
 
Malan DH, Heath ES, Bacal HA, et al: Psychodynamic changes in untreated neurotic patients, II: apparently genuine improvement. Arch Gen Psychiatry 32:110–126, 1975
[PubMed]
 
McEwen BS: Plasticity of the hippocampus: adaptation to chronic stress and allostatic load. Ann N Y Acad Sci 933:265–277, 2001
[PubMed]
 
McLaughlin JT: Transference, psychic reality, and countertransference. Psychoanal Q 50:639–664, 1981
[PubMed]
 
McNeilly CL, Howard KI: The effects of psychotherapy: a reevaluation based on dosage. Psychother Res 1:74–78, 1991
[PubMed]
 
Meaney MJ: Maternal care, gene expression and the transmission of individual differences in stress reactivity across generations. Annu Rev Neurosci 24:1161–1192, 2001
[PubMed]
 
Milrod B, Busch F, Leon AC, et al: Open trial of psychodynamic psychotherapy for panic disorder: a pilot study. Am J Psychiatry 157:1878–1880, 2000
[PubMed]
 
Mitchell S, Aron L (eds): Relational Psychoanalysis: The Emergence of a Tradition. Hillsdale, NJ, Analytic Press, 1999
 
Mohl PC: Listening to the patient, in Psychiatry, 2nd Edition. Edited by Tasman A, Kay J, Lieberman JA. New York, Wiley, 2003, pp 3–18
 
Moran G, Fonagy P, Kurt A, et al: A controlled study of the psychoanalytic treatment of brittle diabetes. J Am Acad Child Adolesc Psychiatry 30:926–935, 1991
[PubMed]
 
Nemiah JC: Foundations of Psychopathology. New York, Oxford University Press, 1961
 
Ogden TH: Analysing forms of aliveness and deadness of the transference-countertransference. Int J Psychoanal 76:695–709, 1995
[PubMed]
 
Olfson M, Marcus SC, Druss B, et al: National trends in the use of outpatient psychotherapy. Am J Psychiatry 159:1914–1920, 2002
[PubMed]
 
Perry C, Bond M: Change in defense mechanisms during long-term dynamic psychotherapy and five-year outcome. Am J Psychiatry 169:916–926, 2012
[PubMed]
 
Perry S, Cooper AM, Michels R: The psychodynamic formulation: its purpose, structure, and clinical application. Am J Psychiatry 144:543–550, 1987
[PubMed]
 
Pine F: The four psychologies of psychoanalysis and their place in clinical work. J Am Psychoanal Assoc 36:571–596, 1988
[PubMed]
 
Poland WS: On the analyst’s neutrality. J Am Psychoanal Assoc 32:283–299, 1984
[PubMed]
 
Rabung S, Leichsenring F: Effectiveness of long-term psychodynamic psychotherapy: first meta-analytic evidence and its discussion, in Psychodynamic Psychotherapy Research: Evidence-Based Practice and Practice-Based Evidence. Edited by Levy RA, Ablon JS, Kachele H. New York, Humana Press, 2012, pp 27–49
 
Racker H: Transference and Countertransference. New York, International Universities Press, 1968
 
Reiser MF: Memory in Mind and Brain: What Dream Imagery Reveals. New Haven, CT, Yale University Press, 1994
 
Rosenthal R: How are we doing in soft psychology? Am Psychol 45:775–777, 1990
[PubMed]
 
Rosenthal R, Rubin DB: A simple, general-purpose display of magnitude of experimental effect. J Educ Psychol 74:166–169, 1982
[PubMed]
 
Sandler J, Dare C, Holder A: The Patient and the Analyst: The Basis of the Psychoanalytic Process. New York, International Universities Press, 1973
 
Schafer R: The atmosphere of safety: Freud’s “Papers on Technique” (1911–1915), in The Analytic Attitude. New York, Basic Books, 1983, pp 14–33
 
Searles HF: Countertransference and Related Subjects. New York, International Universities Press, 1979
 
Shapiro D: Neurotic Styles. New York, Basic Books, 1965
 
Shedler J: The efficacy of psychodynamic psychotherapy. Am Psychol 65:98–109, 2010
[PubMed]
 
Shedler J: The efficacy of psychodynamic psychotherapy, in Psychodynamic Psychotherapy Research: Evidence-Based Practice and Practice-Based Evidence. Edited by Levy RA, Ablon JS, Kachele H. New York, Humana Press, 2012, pp 9–25
 
Silberman EK, Certa K: The psychiatric interview: settings and techniques, in Psychiatry, 2nd Edition. Edited by Tasman A, Kaye J, Lieberman J. New York, Wiley, 2003, pp 30–51
 
Smith ML, Glass GV, Miller TI: The Benefits of Psychotherapy. Baltimore, MD, Johns Hopkins University Press, 1980
 
Sonnenberg SM, Sutton L, Ursano RJ: Physician-patient relationship, in Psychiatry. Edited by Tasman A, Kay J, Lieberman JA. Philadelphia, PA, WB Saunders, 1996, pp 41–49
 
Sonnenberg SM, Ursano AM, Ursano RJ: Physician-patient relationship, in Psychiatry, 2nd Edition. Edited by Tasman A, Kay J, Lieberman JA. New York, Wiley, 2003, pp 52–63
 
Spiegel D, Bloom J, Kraemer H, et al: Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 2:888–891, 1989
[PubMed]
 
Stone L: Notes on the noninterpretive elements in the psychoanalytic situation and process. J Am Psychoanal Assoc 29:89–118, 1981
[PubMed]
 
Sullivan HS: The Psychiatric Interview. New York, WW Norton, 1954
 
Ticho E: Termination of psychoanalysis: treatment goals, life goals. Psychoanal Q 41:315–333, 1972
[PubMed]
 
Ursano RJ, Fullerton CS: Psychotherapy: medical intervention and the concept of normality, in Normality: Context and Theory. Edited by Offer D, Sabshin M. New York, Basic Books, 1991, pp 39–59
 
Ursano RJ, Silberman EK: Individual psychotherapies, in The American Psychiatric Press Textbook of Psychiatry. Edited by Talbott JA, Hales RE, Yudofsky SC. Washington, DC, American Psychiatric Press, 1988, pp 855–889
 
Ursano RJ, Silberman EK, Diaz A Jr: The psychotherapies: basic theoretical principles, techniques and indications, in Clinical Psychiatry for Medical Students. Edited by Stoudemire A. Philadelphia, PA, JB Lippincott, 1990, pp 855–890
 
Weissman MM, Verdell H, Gameroff JM, et al: National survey of psychotherapy training psychiatry, psychology and social work. Arch Gen Psychiatry 63:925–934, 2006
[PubMed]
 
Winkley K, Ismail K, Landau S, et al: Psychological interventions to improve glycaemic control in patients with type 1 diabetes: systematic review and meta-analysis of randomized controlled trials. BMJ 333:55–56, 2006
[PubMed]
 
Zetzel ER: Current concepts of transference. Int J Psychoanal 37:369–376, 1956
[PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
Articles
Books
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 29.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 25.  >
Textbook of Psychotherapeutic Treatments > Chapter 1.  >
Textbook of Psychotherapeutic Treatments > Chapter 2.  >
Textbook of Psychotherapeutic Treatments > Chapter 3.  >
Topic Collections
Psychiatric News
PubMed Articles
 
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation