Abstract
If a patient comes for psychotherapy or psychoanalysis, why medicate him with psychotropic drugs? The answers to this question are explored and addressed from several points of view. The central hypothesis of this paper suggests that most of the reasons for medicating patients have to do with therapist's unresolved countertransference issues. Furthermore, medicating a patient may have deleterious effects on his introjected sense of self, and impacts the transference relationship in a significant way. The issues surrounding medication as adjunctive therapy are elucidated and clarified in terms of rationale, efficacy, and the impact on the psychotherapeutic relationship. Psychoanalytic solutions are offered and discussed.
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References
Alanen, Y.O. (1991). Psychotherapy of schizophrenia in community psychiatry. Paper presented at the Xth International Symposium for the Psychotherapy of Schizophrenia, August, Stockholm, Sweden.
Alexander, F. (1948). Fundamentals in psychoanalysis. New York: W.W. Norton.
Benedetti, G. & Furlan, P.M. (1987). Individual psychoanalytic psychotherapy of schizophrenia. In G. Benedetti (Ed.), Psychotherapy of schizophrenia (pp. 198–212). New York: New York University Press.
Bleuler, M. (1978). The schizophrenic disorders: Long term patient and family studies. New Haven, CT and London: Yale University Press.
Bockovern, J.S. (1972). Moral treatment in community mental health. New York: Springer.
Breggin, P.R. (1990). Brain damage, dementia, and persistent cognitive dysfunction associated with neuroleptic drugs: Evidence, etiology, implications. Journal of Mind and Behavior, 11, 425–464.
Breggin, P.R. (1991). Toxic psychiatry. New York: St. Martin's.
Breggin, P.R. (1997). Brain-disabling treatments in psychiatry: Drugs, electroshock and the role of the FDA. New York: Springer.
Breggin, P. (2001). The antidepressant fact book: What your doctor won’t tell you about Prozac, Zoloft, Paxil, Celexa and Luvox. New York: Perseus Books.
Breggin, P. (2008). Medication madness: A psychiatrist exposes the dangers of mood-altering drugs. New York: St. Martin's.
Breggin, P.R. & Cohen, D. (1999). Your drug may be your problem. New York: Perseus Books.
Carlat, D. (2010). Unhinged: The trouble with psychiatry. New York: Free Press.
Ciompi, L. (1980). Catamnesic long-term study on the course of life and aging of schizophrenics. Schizophrenia Bulletin, 6, 606–617.
Colbert, T.C. (2000). The Four False Pillars of Bio-psychiatry: One hundred years of medical nonsense. Paper presented at the 2002 International Center for the Study of Psychiatry and Psychology, Inc. Conference in Los Angeles, California.
Damsa, C. et al. (2010). Are psychiatric residents still interested in psychoanalysis? A brief report. American Journal of Psychoanalysis, 70 (4), 386–391.
Federn, P. (1943). Psychoanalysis of psychosis: I. Psychiatric Quarterly, 17, 3–19.
Ferenczi, S. (1909). Introjection and transference. In First contributions to psychoanalysis, E. Jones (Trans)., (pp. 35–93). New York: Brunner/Mazel, 1980.
Ferenczi, S. (1980 [1931]). Child analysis in the analysis of adults. In Final contributions to the problems and methods of psychoanalysis (pp. 126–142). New York: Brunner/Mazel Publishers.
Ferenczi, S. (1988 [1932]). The clinical diary of Sándor Ferenczi. J. Dupont (Ed.). Cambridge, MA and London, England: Harvard University Press.
Fisher, S. & Greenberg, R.P. (Eds.) (1989). The limits of biological treatments for psychological distress: Comparisons with psychotherapy and placebo. Hillsdale, NJ: Erlbaum.
Fromm-Reichmann, F. (1950). Principles of intensive psychotherapy. Chicago, IL: University of Chicago Press.
Harding, C.M. (1995). The interaction of biopsychosocial factors, time and course of schizophrenia. In C.L. Shriqui & H.A. Nasrallah (Eds.), Contemporary issues in the treatment of schizophrenia (pp. 653–681). Washington, D.C.: American Psychiatric Press.
Harding, C.M., Zubin, J. & Strauss, J.S. (1987). Chronicity in schizophrenia: Fact, partial fact, or artifact? Hospital and Community Psychiatry, 38, 477–486.
Healy, D. (2000). Emergence of antidepressant induced suicidality. Primary Care Psychiatry, 6, 23–28.
Hegarty, J.D., Baldessarini, R.J., Tohen, M., Waternaux, C. & Oepen, G. (1994). One hundred years of schizophrenia: A meta-analysis of the outcome literature. American Journal of Psychiatry, 151, 1409–1416.
Karon, B.P. (1989). Psychotherapy vs. medication for schizophrenia: Empirical comparisons. In S. Fisher & R.P. Greenberg (Eds.), The limits of biological treatments for psychological distress: Comparisons with psychotherapy and placebo (pp. 105–150). Hillsdale, NJ: Erlbaum.
Karon, B.P. (1994). The Tragedy of Schizophrenia. Tustin, CA: Kevco Publishing.
Karon, B.P. & VandenBos, G.R. (1981). Psychotherapy of schizophrenia: The treatment of choice. New York: Jason Aronson.
Lewontin, R.C., Rose, S. & Kamin, L.J. (1984). Not in our genes. New York: Pantheon.
Lidz, T. & Blatt, S. (1983). Critique of the Danish-American studies of the biological and adoptive relatives of adoptees who became schizophrenic. American Journal of Psychiatry, 140, 426–435.
Lidz, T., Blatt, S. & Cook, B. (1981). Critique of the Danish-American studies of the adopted-away offspring of schizophrenic patients. American Journal of Psychiatry, 138, 1063–1068.
Racker, H. (1968). Transference and countertransference. New York: International Universities Press.
Searles, H.F. (1965). Collected papers on schizophrenia and related subjects. New York: International Universities Press.
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65 (2), 98–109.
Spotnitz, H. (2004 [1969]). Modern Psychoanalysis of the Schizophrenic Patient (Second Edition). New York: Your Book Publisher.
Sullivan, H.S. (1953). Schizophrenia as a human process. New York: Norton.
Tienari, P. (1992). Interaction between genetic vulnerability and rearing environment. In A. Werbart & J. Cullberg (Eds.), Psychotherapy of schizophrenia: Facilitating and obstructive factors, pp. 154–172. Oslo, Norway: Scandinavian University Press.
Valenstein, E.S. (1986). Great and desperate cures: The rise and decline of psychosurgery and other radical treatments for mental illness. New York: Basic Books.
Wender, P.H., Rosenthal, D., Kety, S.S., Schulsinger, F. & Welner, J. (1974). Cross-fostering: A research strategy for clarifying the role of genetic and experiential factors in the etiology of schizophrenia. Archives of General Psychiatry, 30, 121–128.
Winnicott, D.W. (1958). Collected papers through pediatrics to psychoanalysis. New York: Basic Books.
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1Ph.D., Executive Director, International Center for the Study of Psychiatry and Psychology, Inc., NYC
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Riccio, D. Medicating Patients in Psychoanalytic Therapy: Implications for Introjection, Transference, and Countertransference. Am J Psychoanal 71, 338–351 (2011). https://doi.org/10.1057/ajp.2011.39
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DOI: https://doi.org/10.1057/ajp.2011.39