Kaplan & Sadock’s Pocket Handbook of Clinical Psychiatry

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Psychotherapies

Introduction Psychotherapy is a therapeutic process to treat psychological problems by way of establishing a relationship between a trained professional and an individual. This treatment modality is established through therapeutic communication, both verbal and nonverbal, as well as various methods to alleviate emotional disturbances, reverse or change maladaptive patterns of behavior, and encour age personality growth and development. It is distinguished from other forms of psychiatric treatment such as somatic therapies (eg, psychopharmacology and convulsive therapies), and it is undergirded by mutual trust between the qualified professional and the patient. Psychoanalysis and Psychoanalytic Psychotherapy Psychoanalysis and psychoanalytic psychotherapy are based on Sigmund Freud’s theories of dynamic unconscious and psychological conflict. The major goal of these forms of therapy is to help the patient develop insight into unconscious conflicts, based on unresolved childhood wishes and manifested as maladaptive behaviors and symptoms, and to develop more adult patterns of interacting and behaving. Psychoanalysis Psychoanalysis is a theory of human mental phenomena and behavior, a method of psychic investigation and research, and a form of psychotherapy originally formulated by Freud. As a method of treatment, it is the most intensive and rigor ous of all types of psychotherapy. The patient is seen three to five times a week, generally for a minimum of several hundred hours over a number of years. The patient lies on a couch with the analyst seated behind, out of the patient’s visual range. The patient attempts to say freely and without censure whatever comes to mind, to associate freely, so as to follow as deeply as possible the train of thoughts to their earliest roots. As a technique for exploring the mental processes, psychoanalysis includes the use of free association and the analysis and interpretation of dreams, resis tances, and transferences. The analyst uses interpretation and clarification to help the patient work through and resolve conflicts that have been affecting the pa tient’s life, often unconsciously. Psychoanalysis requires that the patient be stable, highly motivated, verbal, and psychologically minded. If they lack motivation or a strong commitment to the psychoanalytic method, it can adversely impact the efficacy of the therapy.

Psychotherapies

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