Posted by violette on July 10, 2011, at 8:35:07
I came across this article today and am posting the link here because i think the lack of psychodynamic thought in mainstream psychiatry today is problematic and needs to be brought to the attention of anyone involved in mental health. People working in the field need to be informed but aren't usually taught this way anymore.
Gabbard, M.D.
"Virtually all major psychiatric disorders are complex amalgams of genetic diatheses and environmental influences.
Rutter has emphasized, Genetic influences, as they apply to individual differences in the liability to show particular behaviors, are strong and pervasive but rarely determinative (4, p. 996). Similarly, psychosocial stressors, such as interpersonal trauma, have profound effects of a biological nature by changing the functioning of the brain.
A review of recent research on personality disorders suggests that these constructs can be dichotomized only in the abstract. In clinical work with patients, mind and brain are intimately connected and can never be separated.
Several implications can be derived from these findings. First, these data illustrate why it is problematic to lump together terms such as genes, brain, and biological, as though they are separate and distinct from terms such as environment, mind, and psychosocial. Psychosocial events may result in persisting biological alterations in the brain. Second, because the HPA axis is intimately linked with serotonergic function, these data suggest the possibility of understanding the mechanism of action of serotonin reuptake inhibitors in patients with borderline personality disorder. Third, because internal object relationships are created from the building blocks of self representations, object representations, and the affects that link the two (32), we can infer that a hypervigilant and anxious affect state will be linked to a perception of objects as persecuting and the self as victimized. Appreciation of this internal object relationship and its affect connection may influence the clinicians psychotherapeutic approach.
The mind-brain relationship has vexed philosophers for centuries and continues to be the subject of controversy. In psychiatric discourse, we often refer to mind and brain as though they are separate entities, even though most psychiatrists in the post-Cartesian era regard the mind as the activity of the brain (1).
With the knowledge that genetic hard-wiring
is a questionable assumption, we have reason to be
optimistic about potential consequences of altering early parental and caregiver interactions with children."http://www.wellcorps.com/files/MindBrainandPersonalityDisorders.pdf
poster:violette
thread:990680
URL: http://www.dr-bob.org/babble/20110630/msgs/990680.html