On the Prescribing Analyst

Abstract

The value of medication for some patients in psychoanalysis serves to highlight the potential challenges of the medical analyst and invites exploration into possible motivations for assuming the prescribing role. Prescribing medication is one way in which the medical analyst integrates the dual identities of physician and analyst while dealing with significant cultural influences and intrapsychic tensions. Technical challenges posed by assuming the prescribing role are explored, as are the potential benefits of split treatment. The educational implications of this argument are discussed in relation to identity formation for candidates who are physicians.

Psychodynamically Oriented Psychopharmacotherapy: Towards a Necessary Synthesis

“…Some analysts argue in favor of sending their patients to a psychopharmacologist for consultation in order to preserve an analytic stance and avoid contamination of the transference (Wylie and Wylie, 1995). Others opt for referring their patients to a psychopharmacologist in order to avoid inadequate pharmacological treatment since answering patients’ questions about the effects/side effects of their medication may lead to a disruption of the analytic process and a forsaking of technical neutrality (Adelman, 1985; Yudofsky, 1991; Vlastelica, 2013; Sandberg, 2014; Salone et al, 2016). Still others prefer to administer the pharmacological treatment and claim that the discussion regarding medications and symptomatic changes may become a positive part of the complex fabric of the analytic relationship (Kandel, 1999; Greene, 2001; Glucksman, 2006; Scull, 2010).…”