Teaching Psychodynamic Technique During an Observed Analytic Psychotherapy Interview

Abstract

Psychodynamic techniques of confrontation, clarification, and interpretation were taught to psychiatry residents during "live" analytic psychotherapy interviews. First, during a therapeutic interview with a resident's patient in a seminar group setting, the interviewer (author) periodically stopped to discuss formulations and technique. Later, the author conducted the interviews until dynamic intervention seemed indicated; at those points, the author stopped, discussed the defenses and affects causing pathology, and then asked a resident to make the psychodynamic intervention with the patient. This teaching technique was rated by the residents as extremely helpful in integrating psychoanalytic theory with clinical interventions.

Can Psychiatry Residents Be Attracted To Analytic Training? a Survey of Five Residency Programs

“…He presented some of his own clinical work and listened to residents' work with attention to unconscious conflict, resistance, and transference. Other authors have demonstrated analytic principles and engaged residents using humor, surprise, and sharply delineated case material (Ingram 2006), group observation of analytic interviews (Blackman 1997;Cardoso Zoppe et al 2009), structured biomedical models applied to individual cases (Melchiode 1991), or integrative models that emphasize multiple ways of viewing the patient (Cabaniss 1998). It is helpful for residents to see how analysts use theoretical principles, how they can integrate a dynamic understanding of the patient with other treatment approaches, and how analysts use themselves and their reactions to patients in deepening their understanding (Cabaniss 1998;Cardoso Zoppe et al 2009;Sonnenberg 1990).…”

“…It is now commonplace for psychiatrists to prescribe medication, while nonphysician psychotherapists provide psychotherapy (Gabbard and Kay 2001). A recent survey of office-based psychiatrists revealed a significant decline in the provision of psychotherapy by psychiatrists, with only 29% of visits to psychiatrists involving psychotherapy in 2004, compared to 44% in 1996-1997(Mojtabai and Olfson 2008. This study also revealed that only 11% of psychiatrists in the U.S. provided psychotherapy to all of their patients in 2004-2005, compared to 19% in 1996-1997.…”