BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently understood.Evidence of differences between different typ...BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently understood.Evidence of differences between different types of therapies has been questioned.AIM To study repetitive interaction patterns in patients with BPD undergoing either psychoanalysis or psychodynamic therapy.METHODS Psychoanalysis(PSA)or psychodynamic psychotherapy(PDT)was administered to 10 patients each,the two groups were matched.Therapy regimens were applied according to care as usual/manualized including quality control and supervision as usual.Randomization to one of the groups was done after baseline assessment.During classical PSA(n=10)and PDT(n=10),semiannually,recordings(audio or video)of five consecutive therapy sessions were taken over three years for an ex-post analysis.The patients'characteristics,such as affect parameters[Affect regulation and experience Q-sort(AREQ)],quality of object relations(quality of object relations scale)and personality traits[Shedler-Westen Assessment Procedure(SWAP-200)]were analyzed retrospectively by independent raters.Therapeutic action(psychotherapy process Q-sort)and affective(re)actions of the patients(AREQ)were then analyzed in relation to changes found in the patients'characteristics.RESULTS During the first year of therapy(PSA:n=10;PDT:n=9),the therapeutic method PSA was associated with significant improvements in the variable"SWAP Borderline",while in PDT change was not significantly different to baseline(PSA:P=0.04;PDT:P=0.33).Long-term results and follow up was available for seven participants in PSA and for five in PDT after three years;change in SWAP borderline for the whole sample was not significant at this time point when confronting to baseline(P=0.545).However,differences between PSA and PDT were significant when analyzing the“mean change”in the SWAP Borderline variable after one year of therapy(P=0.024):PSA led to slightly increased BPD symptoms,while PDT to a decrease;for the long run,variance of observed change was higher in PSA than in PDT(SDPSA±9.29 vs SDPDT±7.94).Our assumption that transference interpretations,closely followed by affective changes in the patient,could be useful modes of interaction was reproducible in our findings,especially when looking at the descriptive findings in the long-term data.The analysis of repetitive interaction structures demonstrated a very specific"time-lag"between therapeutic intervention and a corresponding increase in positive affect in successful therapy cases.CONCLUSION Exploring the change processes in the patients'characteristics and linking these changes to specific treatment strategies is of clinical importance when starting treatment and for its long-term progress.展开更多
Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depress...Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depressive symptoms are formulated as responses to impaired mentalisation.DIT aims to alleviate depressive symptoms by improving mentalising.Aims This study aimed to examine the effect of DIT on improving mentalising and the mediating effect of mentalising in changes in depressive symptoms.Methods Outpatients received either DIT combined with antidepressant medication treatment(DIT group)or antidepressant medication treatment alone(ADM group)for 16 weeks.The Hamilton Depression Rating Scale(HAMD),Patient Health Questionnaire(PHQ)and Reflective Functioning Questionnaire(RFQ)were used.The intention-to-treat principle,mixed linear models,multiple imputation,Pearson's correlation analysis and mediation analysis were conducted.The per-protocol principle was used as sensitivity analysis.Results The DIT group had significantly lower HAMD(least-squares(LS)mean difference=-3.756,p<0.001),PHQ(LS mean difference=-4.188,p<0.001),uncertainty about mental states in the RFQ(RFQ-U,LS mean difference=-2.116,p<0.001)and higher certainty about mental states in the RFQ(RFQ-C,LS mean difference=2.214,p=0.028)scores than the ADM group at post-treatment.The change in RFQ-C was marginally significantly correlated with the change in HAMD(r=-0.218,poretao=0.090),The change in RFQ-U was significantly correlated with the change in HAMD(r=-0.269,poroco-0.024)and the change in PHQ(r=-0.43,Peoretceo l<e0.001).When using RFQ-U as the mediating variable and PHQ as the dependent variable,a significant mediating effect was found(p=0.043,95% confidence interval 0.024 to 1.453).Conclusions The DIT group yielded better outcomes compared with the ADM group in reducing depressive symptoms and improving mentalising.Improvements in mentalising were associated with reductions in depressive symptoms.These findings support that mentalising may contribute to the therapeutic effects of DIT in MDD.展开更多
In child psychiatry, the use of play, a habitual activity in children, is used as a means of communication and therapy. The psychodynamic reading of a sequence of games played by a three-year-old child with dolls, who...In child psychiatry, the use of play, a habitual activity in children, is used as a means of communication and therapy. The psychodynamic reading of a sequence of games played by a three-year-old child with dolls, who had been treated for anorexia for a year at the Children’s Guidance Center of Abidjan, shed new light on the child’s problems. The clinical history of M (3 years old) revealed, in addition to the eating disorder, a disturbance in the attachment bond and parental imagos in distress. This doll game, set up as a copy of reality, enabled the therapist to redirect his treatment and work on the mother-child bond.展开更多
The quality of object relations affects interpersonal behaviour, but it is not known whether it modifies effectiveness on personality functioning in psychotherapies of different mode and length. In this study we estim...The quality of object relations affects interpersonal behaviour, but it is not known whether it modifies effectiveness on personality functioning in psychotherapies of different mode and length. In this study we estimated the modifying effect of the quality of object relations on the effect of solution-focused therapy (SFT) and shortand long-term psychodynamic psychotherapy (SPP and LPP) on self-concept. A total of 326 patients were assessed at baseline with the Quality of Object Relations Scale (QORS) and 4 times during a 3-year follow-up with the Structural Analysis of Social Behavior self-concept questionnaire, comprising altogether 10 scores on different aspects of self-concept pathology. The effectiveness of SFT, but not SPP, was significantly poorer in several domains (5/10) of self-concept for patients with low QORS, i.e. those with less mature relational patterns, than for patients with high QORS, while the reversal occurred in some (3/10) self-concept domains in LPP. The results suggest that the quality of object relations has significance for treatment selection in therapies with different mode and length.展开更多
Tagore reaches his lord through his songs which uplift him above the meanness end of life. Music ennobles him to a level of friendship with the Creator. Tagore＇s poems are suffused with wonder at the melodies spun by...Tagore reaches his lord through his songs which uplift him above the meanness end of life. Music ennobles him to a level of friendship with the Creator. Tagore＇s poems are suffused with wonder at the melodies spun by the lord. These entrance the entire universe. The poet wants to sign the same way but cannot. He has been made captive in the meshes of his music. The objective of the present study is to show how Tagore unites with God through songs. Methodology adopted in this study is the dynamic analysis of the poems. The intrinsic idea is the recurrent theme in his songs using me as an offering of worship O Lord, even if thou inflict pain on me in the process. Numerous bereavements in his life, from early youth to old age, agonized him throughout. But the more he suffered, the stronger grew his faith so he could write this song. The refrain, re-iterated from the beginning to the end, enhances the musicality. Thus it can be concluded when the poet perceived the world through songs, then he knew the world and he recognized it.展开更多
Life was full of pathos and stress to Tagore. Tagore remains preoccupied with the irrecoverable losses but finally has felt--soothing thought spring out of human suffering. He did not grieve rather find strengths in w...Life was full of pathos and stress to Tagore. Tagore remains preoccupied with the irrecoverable losses but finally has felt--soothing thought spring out of human suffering. He did not grieve rather find strengths in what remains behind. The poet has gained abundant pleasure from the natural world knowing nature never did betray. Psychodynamically by identifying and introjecting mother figure he felt the most enduring human passion--＂Serenity＂. Thus despite the barriers of time and space, nation and race, Tagore as an affectionate father may embrace fellow human beings most endearingly. The principal objective is to probe Tagore＇s psychodynamics and creative processes. Dynamic analysis was done by following the methods of Freud, Jung, and Kris. Findings highlighted that Tagore was a man who could be rightly called ＂Lord of speech with mind for all＂.展开更多
This report explored psychodynamic developments that adolescents undergo in their process of self-realization and self-identification, including separation-individuation and ego development. The paper maked a case for...This report explored psychodynamic developments that adolescents undergo in their process of self-realization and self-identification, including separation-individuation and ego development. The paper maked a case for art therapy as a resource and non-confrontational outlet to guide adolescents through their development and search for their self-identity. The role of the art therapist is presented as an alternative source of support and containment which may be lacking through the adolescents’ peers and parents. The paper ultimately argued that art therapy had many therapeutic qualities that could help the adolescent in their search and consolidation of the self.展开更多
文摘BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently understood.Evidence of differences between different types of therapies has been questioned.AIM To study repetitive interaction patterns in patients with BPD undergoing either psychoanalysis or psychodynamic therapy.METHODS Psychoanalysis(PSA)or psychodynamic psychotherapy(PDT)was administered to 10 patients each,the two groups were matched.Therapy regimens were applied according to care as usual/manualized including quality control and supervision as usual.Randomization to one of the groups was done after baseline assessment.During classical PSA(n=10)and PDT(n=10),semiannually,recordings(audio or video)of five consecutive therapy sessions were taken over three years for an ex-post analysis.The patients'characteristics,such as affect parameters[Affect regulation and experience Q-sort(AREQ)],quality of object relations(quality of object relations scale)and personality traits[Shedler-Westen Assessment Procedure(SWAP-200)]were analyzed retrospectively by independent raters.Therapeutic action(psychotherapy process Q-sort)and affective(re)actions of the patients(AREQ)were then analyzed in relation to changes found in the patients'characteristics.RESULTS During the first year of therapy(PSA:n=10;PDT:n=9),the therapeutic method PSA was associated with significant improvements in the variable"SWAP Borderline",while in PDT change was not significantly different to baseline(PSA:P=0.04;PDT:P=0.33).Long-term results and follow up was available for seven participants in PSA and for five in PDT after three years;change in SWAP borderline for the whole sample was not significant at this time point when confronting to baseline(P=0.545).However,differences between PSA and PDT were significant when analyzing the“mean change”in the SWAP Borderline variable after one year of therapy(P=0.024):PSA led to slightly increased BPD symptoms,while PDT to a decrease;for the long run,variance of observed change was higher in PSA than in PDT(SDPSA±9.29 vs SDPDT±7.94).Our assumption that transference interpretations,closely followed by affective changes in the patient,could be useful modes of interaction was reproducible in our findings,especially when looking at the descriptive findings in the long-term data.The analysis of repetitive interaction structures demonstrated a very specific"time-lag"between therapeutic intervention and a corresponding increase in positive affect in successful therapy cases.CONCLUSION Exploring the change processes in the patients'characteristics and linking these changes to specific treatment strategies is of clinical importance when starting treatment and for its long-term progress.
基金funded by Science and Technology Commission of Shanghai Municipality(No.21Y11905400)National Natural ScienceFoundationof China(General Program,No.82371555).
文摘Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depressive symptoms are formulated as responses to impaired mentalisation.DIT aims to alleviate depressive symptoms by improving mentalising.Aims This study aimed to examine the effect of DIT on improving mentalising and the mediating effect of mentalising in changes in depressive symptoms.Methods Outpatients received either DIT combined with antidepressant medication treatment(DIT group)or antidepressant medication treatment alone(ADM group)for 16 weeks.The Hamilton Depression Rating Scale(HAMD),Patient Health Questionnaire(PHQ)and Reflective Functioning Questionnaire(RFQ)were used.The intention-to-treat principle,mixed linear models,multiple imputation,Pearson's correlation analysis and mediation analysis were conducted.The per-protocol principle was used as sensitivity analysis.Results The DIT group had significantly lower HAMD(least-squares(LS)mean difference=-3.756,p<0.001),PHQ(LS mean difference=-4.188,p<0.001),uncertainty about mental states in the RFQ(RFQ-U,LS mean difference=-2.116,p<0.001)and higher certainty about mental states in the RFQ(RFQ-C,LS mean difference=2.214,p=0.028)scores than the ADM group at post-treatment.The change in RFQ-C was marginally significantly correlated with the change in HAMD(r=-0.218,poretao=0.090),The change in RFQ-U was significantly correlated with the change in HAMD(r=-0.269,poroco-0.024)and the change in PHQ(r=-0.43,Peoretceo l<e0.001).When using RFQ-U as the mediating variable and PHQ as the dependent variable,a significant mediating effect was found(p=0.043,95% confidence interval 0.024 to 1.453).Conclusions The DIT group yielded better outcomes compared with the ADM group in reducing depressive symptoms and improving mentalising.Improvements in mentalising were associated with reductions in depressive symptoms.These findings support that mentalising may contribute to the therapeutic effects of DIT in MDD.
文摘In child psychiatry, the use of play, a habitual activity in children, is used as a means of communication and therapy. The psychodynamic reading of a sequence of games played by a three-year-old child with dolls, who had been treated for anorexia for a year at the Children’s Guidance Center of Abidjan, shed new light on the child’s problems. The clinical history of M (3 years old) revealed, in addition to the eating disorder, a disturbance in the attachment bond and parental imagos in distress. This doll game, set up as a copy of reality, enabled the therapist to redirect his treatment and work on the mother-child bond.
文摘The quality of object relations affects interpersonal behaviour, but it is not known whether it modifies effectiveness on personality functioning in psychotherapies of different mode and length. In this study we estimated the modifying effect of the quality of object relations on the effect of solution-focused therapy (SFT) and shortand long-term psychodynamic psychotherapy (SPP and LPP) on self-concept. A total of 326 patients were assessed at baseline with the Quality of Object Relations Scale (QORS) and 4 times during a 3-year follow-up with the Structural Analysis of Social Behavior self-concept questionnaire, comprising altogether 10 scores on different aspects of self-concept pathology. The effectiveness of SFT, but not SPP, was significantly poorer in several domains (5/10) of self-concept for patients with low QORS, i.e. those with less mature relational patterns, than for patients with high QORS, while the reversal occurred in some (3/10) self-concept domains in LPP. The results suggest that the quality of object relations has significance for treatment selection in therapies with different mode and length.
文摘Tagore reaches his lord through his songs which uplift him above the meanness end of life. Music ennobles him to a level of friendship with the Creator. Tagore＇s poems are suffused with wonder at the melodies spun by the lord. These entrance the entire universe. The poet wants to sign the same way but cannot. He has been made captive in the meshes of his music. The objective of the present study is to show how Tagore unites with God through songs. Methodology adopted in this study is the dynamic analysis of the poems. The intrinsic idea is the recurrent theme in his songs using me as an offering of worship O Lord, even if thou inflict pain on me in the process. Numerous bereavements in his life, from early youth to old age, agonized him throughout. But the more he suffered, the stronger grew his faith so he could write this song. The refrain, re-iterated from the beginning to the end, enhances the musicality. Thus it can be concluded when the poet perceived the world through songs, then he knew the world and he recognized it.
文摘Life was full of pathos and stress to Tagore. Tagore remains preoccupied with the irrecoverable losses but finally has felt--soothing thought spring out of human suffering. He did not grieve rather find strengths in what remains behind. The poet has gained abundant pleasure from the natural world knowing nature never did betray. Psychodynamically by identifying and introjecting mother figure he felt the most enduring human passion--＂Serenity＂. Thus despite the barriers of time and space, nation and race, Tagore as an affectionate father may embrace fellow human beings most endearingly. The principal objective is to probe Tagore＇s psychodynamics and creative processes. Dynamic analysis was done by following the methods of Freud, Jung, and Kris. Findings highlighted that Tagore was a man who could be rightly called ＂Lord of speech with mind for all＂.
文摘This report explored psychodynamic developments that adolescents undergo in their process of self-realization and self-identification, including separation-individuation and ego development. The paper maked a case for art therapy as a resource and non-confrontational outlet to guide adolescents through their development and search for their self-identity. The role of the art therapist is presented as an alternative source of support and containment which may be lacking through the adolescents’ peers and parents. The paper ultimately argued that art therapy had many therapeutic qualities that could help the adolescent in their search and consolidation of the self.
