Silvio Joseph R, Condemarín Raúl
The Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
J Am Acad Psychoanal Dyn Psychiatry. 2011 Spring;39(1):27-39. doi: 10.1521/jaap.2011.39.1.27.
Over the past 20 years, the previously frowned upon combination of pharmacotherapy and psychoanalytic or psychodynamic therapy has become common practice because of both findings from the neurosciences that demonstrate hardwired brain development from chronic early stress and trauma and from efficacy studies that show the superiority of combined therapy over either psychotherapy or medication alone. With this shift has also come a more focused interest in the psychodynamics of pharmacotherapy itself. This article will review some of the current thinking in this area and then present the personal approaches toward pharmacotherapy of two psychoanalysts, one at an academic hospital (RC) and the other in private practice (JS).
在过去20年里,药物治疗与精神分析或心理动力治疗这种先前不被看好的组合已成为常见做法,这既是因为神经科学的研究结果表明慢性早期应激和创伤会对大脑发育产生固有影响,也是因为疗效研究显示联合治疗比单独的心理治疗或药物治疗更具优势。随着这种转变,人们对药物治疗本身的心理动力学也有了更集中的关注。本文将回顾该领域当前的一些观点,然后介绍两位精神分析学家对药物治疗的个人方法,一位在学术医院(RC),另一位从事私人执业(JS)。