Discussion with Author David Mintz, MD with interview by Catherine Stevenson, MD

This event would be of interest to a general audience of psychodynamic clinicians as well as those who prescribe medications. Though the book is generally aimed at prescribers, with a framework for how to integrate psychodynamic understandings and techniques to address dynamics driving treatment resistance, Dr. Mintz and Dr. Stevenson plan to focus their interview on the first part of the book. Those sections focus on (1) how the data challenges assumptions about mind-body dualism, (2) ways that pharmacotherapy and the prescribing act (and interprofessional relations) are suffused with dynamics, and (3) psychodynamics driving treatment resistance in patients who are prescribed medications.

The histories of psychoanalysis and biomedical psychiatry have promoted a polarization between these disciplines. Often, this has led psychoanalysts to adopt a narrowly biomedical view of psychopharmacology (while simultaneously being critical of biopsychiatry for holding a biomedically-reductionist focus). Under scrutiny, a dualistic understanding of pharmacotherapy breaks down. In many cases, psychiatric medications are even more symbolically-active than they are directly biologically-active. Psychoanalysis has much to say about symbolic aspects of pharmacotherapy and clinically-meaningful aspects of the therapeutic relationship that can be helpful to psychiatry. At the same time, polarization has promoted a general neglect of interactions of pharmacotherapy and psychoanalysis, despite the fact that a large percentage of analysands are now receiving both treatments. In this discussion, we will consider a specific model for integrating psychodynamics and pharmacotherapy, Psychodynamic Psychopharmacology, as well as broader questions of the relationship of psychoanalysis and pharmacotherapy.