Description
Some wonder whether psychoanalysis and a psychodynamic perspective remain relevant in psychiatry. This presentation argues that the answer is a resounding “Yes,” especially when dealing with patients we come to experience as “difficult” and/or as not responding to treatment. The presentation reviews competition between biomedical and biopsychosocial models of psychiatry, suggesting that evidence from neuroscience and genomic research better supports core assumptions of a biopsychosocial rather than a biomedical model. The presentation demonstrates how failure to attend adequately to biopsychosocial and psychodynamic issues contributes to the experience of patients as “difficult” and to the phenomenon of treatment resistance, especially in patients with significant childhood adversity and personality disorders. It then uses jargon-free language to review and illuminate concepts from psychoanalysis that are relevant to biopsychosocial, psychodynamic engagement of those patients we experience as “difficult” or presenting with treatment resistant disorders. These concepts include a psychodynamic perspective on the therapeutic alliance, the uses and pitfalls of transference and countertransference, the utility of a psychodynamic approach to psychopharmacology, and problems that are likely to arise in work with patients with immature defenses and/or trauma histories. The presentation explains the concept of enactment in ordinary language, including how to detect, analyze, and make use of enactments in clinical work, and addresses how selection of the most appropriate level of care can improve outcomes.
Format
Recorded webinar.
This content was recorded during the APA 2024 Annual Meeting.
Learning Objectives
- Utilize psychodynamic principles to improve outcomes with patients experienced as “difficult”
- Describe evidence that supports a biopsychosocial over a biomedical model for psychiatry.
- List psychosocial factors contributing to the phenomenon of treatment resistance.
- Anticipate and respond to transference paradigms with survivors of abuse.
Target Audience
Residents/Fellows, Psychiatrists, Psychologists
Estimate Time to Complete
Estimated Duration: 1.5 hours
Program Start Date: May 17, 2025
Program End Date: May 17, 2028
How to Earn Credit
Participants who wish to earn AMA PRA Category 1 Credit™ may do so after completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned.
Continuing Education Credit
In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
The APA designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Instructors
- Dhruv Gupta, MD, MS
- Eric Plakun, MD, DLFAPA, FACPsych
- Samar Habl, MD
Planners
- Vishal Madaan, MD, Chief of Education and Deputy Medical Director at the American Psychiatric Association.
Accessibility for Participants with Disabilities
The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. Please contact the American Psychiatric Association at 202-559-3900, if you require assistance seven (7) business days prior to the start of a live webinar.
Technical Requirements
This internet-based CME activity is best experienced using any of the following:
- The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
- Internet Explorer 11+
This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.
Optimal System Configuration:
- Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
- Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
- Internet Connection: 1 Mbps or higher
Minimum Requirements:
- Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
- Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content
For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance