Murawiec Sławomir
II Kliniki Psychiatrycznej AM w Warszawie.
Psychiatr Pol. 2004 Jul-Aug;38(4):707-16.
Psychoanalytic exploration of the action of psychotropic drugs has a long tradition which begins in the pioneer days of contemporary psychopharmacotherapy in 1950-ties. This exploration and publications based on them theorized about influence of neuroleptics on ego defences, id drives and intrapsychic conflicts and decrease in symptomatology as a result of action of the medication on all listed above. The paper presented is the case story about psychodynamic meaning of medication with a neuroleptic drug in a new context. The patient after a psychotic episode (paranoid type) was treated with quetiapine 600 mg per day and in the same time had an individual psychotherapy. During psychotherapy her inability to establish object stability was disclosed. In that particular intrapsychic situation the patient established a relation with an omnipotent and idealized representation of the drug. Medication was an absolutely idealized object for her one that was controllable and stabile and could not abandon her. The quality of relation with the drug was based on a primary defence mechanism like splitting, idealization and omnipotence and denial.
对精神药物作用的精神分析探索有着悠久的传统，始于20世纪50年代当代精神药物治疗的开创时期。这种探索以及基于此的出版物对神经阻滞剂对自我防御、本我驱力和心理内部冲突的影响进行了理论化，并认为药物作用于上述所有方面会导致症状减轻。本文呈现的是一个关于在新背景下使用神经阻滞剂药物的心理动力学意义的病例故事。一名患者在经历一次精神病发作（偏执型）后，每天服用600毫克喹硫平，同时接受个体心理治疗。在心理治疗过程中，发现她无法建立客体稳定性。在那种特定的心理内部情境中，患者与药物的一种全能且理想化的表象建立了关系。药物对她来说是一个绝对理想化的客体，是可控且稳定的，不会抛弃她。与药物的关系质量基于诸如分裂、理想化、全能和否认等初级防御机制。
