Lurie S N
Outpatient Division, Duke University Medical Center, Durham, N.C. 27710.
Am J Psychother. 1991 Jul;45(3):348-58. doi: 10.1176/appi.psychotherapy.1991.45.3.348.
Recent advances in neuroscience and psychopharmacology have been tremendously effective in expanding our ability to help our patients. However, these techniques too are limited and in our excitement at the advance of science and under the increasing pressures for simple answers and rapid treatment we must be careful not to ignore our patients' intrapsychic lives. Failing to consider the psychodynamic implications of the chemical imbalance and of prescribing medications sets the stage for the transference to be repetitively acted out around medication issues. By taking a psychodynamically informed approach to the treatment of patients the psychiatrist is prepared to provide comprehensive care and make better decisions regarding the appropriateness or timing of medications and may avoid participating in the patients' repetitions.
神经科学和精神药理学的最新进展在极大程度上有效地拓展了我们帮助患者的能力。然而,这些技术也存在局限性,在我们为科学进步感到兴奋以及面对寻求简单答案和快速治疗的压力不断增加的情况下,我们必须谨慎,切勿忽视患者的内心生活。若不考虑化学失衡以及开药的心理动力学影响,就会为围绕药物问题反复上演移情行为创造条件。通过采用基于心理动力学的方法来治疗患者,精神科医生就能做好准备提供全面护理,并在药物的适用性或用药时机方面做出更好的决策,还可避免卷入患者的重复行为模式。