MD, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
Am J Psychoanal. 2024 Jun;84(2):285-310. doi: 10.1057/s11231-024-09444-y.
Since its inception, psychiatry has undergone several periods of radical identity transformation. Initially limited to psychotherapy alone, the advent of medications stimulated an era of biological psychiatry. For years, medications served as the mainstay of biological treatments, paralleled by a rise in treatment resistance. Brain stimulation therapies are psychiatry's newest arm of intervention and represent an area ripe for exploration. These techniques offer new hope to treatment-resistant patients, but in a manner often dissociated from psychoanalytic conceptualization and the practice of psychotherapy. There is growing interest in bridging this divide. In this article, we continue the efforts at interweaving what may seem to be disparate approaches through the topic of treatment resistance. This article aims to engage interventional psychiatrists in considering psychosocial dimensions of their treatments and to provide education for psychoanalytic clinicians on the history, mechanism of action, and applications of brain stimulation technologies.
自创立以来,精神病学经历了几次彻底的身份转变。最初仅限于心理治疗,随着药物的出现,迎来了生物精神病学的时代。多年来,药物一直是生物治疗的主要手段,同时也出现了治疗抵抗的增加。脑刺激疗法是精神病学干预的最新手段,代表了一个有待探索的领域。这些技术为治疗抵抗的患者带来了新的希望,但往往与精神分析概念化和心理治疗实践脱节。人们越来越有兴趣弥合这一差距。在本文中,我们继续通过治疗抵抗这一主题,努力将看似不同的方法交织在一起。本文旨在促使介入精神病学家考虑其治疗的社会心理维度,并为精神分析临床医生提供关于脑刺激技术的历史、作用机制和应用的教育。