Psychodynamic Psychopharmacology: Caring for the Treatment-Resistant Patient (4 of 4) - David L. Mintz, MD (Recorded)
Course 4 of 4 - The Art of Pharmacotherapy: Enhancing Outcomes by Integrating Patient-Centered, Psychodynamically-Informed Perspectives
Other Courses in this Series:
- Thinking About Prescribing: Psychodynamically-Informed, Patient-Centered Approaches to Pharmacotherapy (1 of 4)
- The Science of the Art of Psychopharmacology: An Introduction to the (Other) Evidence Base (2 of 4)
- Psychodynamics of Pharmacologic Treatment-Resistance (3 of 4)
Though psychiatry has benefited from an increasingly evidence-based perspective and a proliferation of safer and more tolerable treatments, outcomes are not substantially better than they were a quarter of a century ago. Treatment resistance remains a serious problem across psychiatric diagnoses. One likely reason is that systems within which psychiatrists are working often create pressures for doctors to adopt a biologically reductionistic framework. In this context, the important impact of psychosocial factors in prescribing have been relatively neglected, leaving psychiatrists to work without some of our most potent tools.
Psychodynamic Psychopharmacology is a psychodynamically-informed, patient-centered approach to psychiatric patients that explicitly acknowledges and addresses the central role of meaning and interpersonal factors in pharmacologic treatment. While traditional objective-descriptive psychopharmacology provides guidance about what to prescribe, the techniques of Psychodynamic Psychopharmacology inform prescribers about how to prescribe to maximize outcomes, not only in terms of addressing symptoms, but also in ways that support the patient’s development, increase the patient’s personal authority as agents in their own recovery, and foster general wellbeing. In this presentation, we will consider specific technical approaches to patients who present with some degree of treatment resistance that develops as a consequence of unhealthy relationships to treatment, treaters, or health itself. Techniques reviewed will include strategies for avoiding a mind-body split, developing an overall diagnosis that includes an understanding of the patient’s ambivalences about treatment, forging a patient-centered alliance while attending to the ways that patients unconsciously resist, and being aware of the prescriber’s dynamic contributions to treatment-resistance.
If you enjoy this subject matter, you may be interested in our upcoming 2023 Virtual Fall Conference, Losing our Mind and Finding It: Re-Integrating Meaning in a Neurobiologically-Focused Era
______ Introductory __x__ Intermediate ______ Advanced
Resist falling into an illness-centered perspective when prescribing
Formulate treatment-interfering dynamics in pharmacotherapy
Demonstrate alliance-promoting behaviors in pharmacotherapy and more effectively engage negative transferences to enhance the pharmacotherapeutic alliance
Use psychodynamically-informed interventions to address dynamics driving treatment-resistance
Recognize and contain countertransference dynamics that might undermine provision of effective pharmacotherapy
- MD from University of Miami School of Medicine
- Residency through the Cambridge Hospital/Austen Riggs Center Combined Residency Program
- Fellowship in psychoanalytic studies at the Austen Riggs Center
David L. Mintz, MD, is a staff psychiatrist who joined the Austen Riggs Center in 1996. He presently serves as the director of psychiatric education, the associate director of training, and as a team leader. He also is principal investigator for the research initiative in Psychodynamic Psychopharmacology and author of the book Psychodynamic Psychopharmacology: Caring for the Treatment-Resistant Patient (2022, American Psychiatric Association Publishing). Dr. Mintz also coordinates the Elective in Psychodynamic Psychiatry at the Austen Riggs Center.
Professional Affiliations/Organizational Memberships
- American Psychiatric Association, former leader of the Psychotherapy Caucus
- American Academy of Psychoanalysis and Dynamic Psychiatry, Psychoanalytic Fellow and elected Trustee
- Editorial Board member of Psychodynamic Psychiatry
- Medical Student Education Committee member of the American Psychoanalytic Association
- Teichner Scholar at Cooper Medical School of Rowan University Psychiatry Residency Program
- Psychological aspects of taking and prescribing medications, psychodynamic aspects of medical education, professionalism, and clinical care of psychiatric patients with treatment-refractory conditions.
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