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Current psychodynamic approaches to psychiatry 

Current psychodynamic approaches to psychiatry
Chapter:
Current psychodynamic approaches to psychiatry
Author(s):

Glen O. Gabbard

DOI:
10.1093/med/9780199696758.003.0040
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date: 16 October 2017

Psychodynamic psychiatry is broadly defined today. In fact, the term psychodynamic is now used almost synonymously with psychoanalytical. Freud originally used the term psychodynamic to emphasize the conflict between opposing intrapsychic forces: a wish was opposed by a defence, and different intrapsychic agencies, such as ego, id, and superego, were in conflict with one another. Indeed, for much of the twentieth century psychoanalytical theory was dominated by the drive-defence model, often referred to as ego psychology. A set of time-honoured basic principles, all derived from psychoanalytical technique and theory, define the overall approach of the dynamic psychiatrists, and these are discussed here. Another key component of the psychodynamic approach is that the clinician treats the person and not just the illness. In practice, that perspective means taking the personality into account in every case, and development of personality is discussed here, as is dynamic pharmacotherapy, multiple-treater settings, two-person context of treatment, and psychodynamic psychotherapy for specific disorders. Finally future directions are discussed.

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