Thomas Zoë
Psychiatry Resident, Department of Psychiatry, McGill University, Montreal, Canada.
Psychodyn Psychiatry. 2017 Spring;45(1):59-77. doi: 10.1521/pdps.2017.45.1.59.
This article recounts the case of a patient with schizophrenia engaged in time-limited psychodynamic psychotherapy with a psychiatry resident-the first case history of its type to the author's knowledge. This patient suffered from chronically debilitating schizophrenia with persistent positive and negative symptoms at the time of treatment, despite usual psychiatric management. He benefited significantly from 18 weekly sessions of weekly dynamic therapy, achieving symptom reduction, increased social involvement, and improved functioning-gains that were sustained at 9-month follow-up. The author narrates the patient's therapeutic progress from a clinician-in-training's perspective, commenting on technical aspects of his treatment. The author examines how the time-limited nature of the therapy may have infused the transference and influenced the patient's outcome. The author also reviews the evidence base for psychodynamic treatment of patients with schizophrenia, focusing on short-term therapy specifically. The author invites greater inquiry into time-limited therapeutic approaches with such patients.
本文讲述了一名精神分裂症患者与一名精神科住院医师进行限时心理动力心理治疗的案例——据作者所知,这是此类的首个病例史。该患者患有慢性致残性精神分裂症,在治疗时尽管接受了常规的精神科治疗,但仍存在持续的阳性和阴性症状。他从每周一次、共18次的动力治疗中获益显著,症状减轻,社会参与度增加,功能得到改善——这些改善在9个月的随访中得以维持。作者从一名实习临床医生的角度叙述了患者的治疗进展,并对其治疗的技术方面进行了评论。作者探讨了治疗的限时性可能如何影响移情并影响患者的治疗结果。作者还回顾了精神分裂症患者心理动力治疗的证据基础,特别关注短期治疗。作者呼吁对这类患者的限时治疗方法进行更多的研究。