Psychodynamics in Medically Ill Patients
| Autor: | Philip R. Muskin, Sara Siris Nash, Laura K. Kent |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Psychotherapist Interprofessional Relations media_common.quotation_subject Personality Assessment Suicide Assisted Adaptation Psychological medicine Humans Personality Psychoanalytic theory Countertransference Somatoform Disorders Referral and Consultation Conversion disorder Defense Mechanisms media_common Patient Care Team Psychiatry Physician-Patient Relations Terminal Care Sick role Sick Role Internship and Residency Psychosomatic medicine Hysteria medicine.disease Psychodynamics Psychoanalytic Therapy Hospitalization Psychiatry and Mental health Conversion Disorder Psychoanalytic Theory Patient Compliance Psychology |
| Zdroj: | Harvard Review of Psychiatry. 17:389-397 |
| ISSN: | 1067-3229 |
| DOI: | 10.3109/10673220903465726 |
| Popis: | This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment. |
| Databáze: | OpenAIRE |
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