Combining Psychopharmacology, Psychotherapy and Psychoanalysis
The advent of safer psychopharmacological agents with less troublesome side effects, along with increasing knowledge of the broad array of syndromes treatable with medication, has led to a vast expansion in treatment options available to the psychiatrist. Clinical research and studies show that using psychotropic drugs when combined and psychoanalysis or psychodynamic psychotherapy occurs more frequently.
Two recent studies show the severity in this direction. A survey of trainers discovered that they had given medications to 20 per cent of their patients during the past five years. A study of training cases for candidates revealed that 30 per cent of their patients were on medications.
The method of integrating psychoanalytic and psychodynamic therapies with psycho-pharmacology thus is worthy of continued study. In many instances, the combination can function synergistically, with psycho-pharmacological interventions aiding the patient's ability to pursue psychoanalytic investigation; these investigations in turn articulate the meaning and impact of taking medication to the patient and therapist.
But, psychodynamic and medication methods can clash theoretically and clinically. Learning to use these diverse listening frameworks as well as data sets and methods is, therefore, quite difficult.
Analytic Bias Against Medication
The debates surrounding the combination of psychoanalysis and medications have been prevalent for quite a while. They originated partly due to the manner psychoanalysts utilized meta-psychological theories to explain character pathology as well as the most serious psychiatric illnesses. While the basis of these theories differs from psychoanalytic theories, however, they all consider psychiatric illnesses in relation to psychodynamic elements. There is a conflict when a psyched nomically-based explanation for a medical condition is seen as a cause. This can lead to an incorrect perception that medications affect only peripheral or secondary symptoms.
This approach has led some psychoanalysts, especially in the past to avoid using psychotropic medications completely. Psychoanalysts historically have seen medication as a hindrance to the development of transference in psychoanalysis, even though it is sometimes required to effectively manage symptoms so that psychoanalytic treatment continues. Furthermore, the use of medication was believed to decrease depressive and anxiety effects, which were major factors in treatment.
Organic Substructure
However, this notion of physiology as a secondary issue is a bit baffling in many ways. The biological and constitutional causes of psychiatric disease are widely acknowledged in the literature on psychoanalysis. I am of the opinion that "all of our theories regarding psychology are likely to eventually be built on an organic structure" and their meta-psychological theories of his were just speculative ideas that were meant to be replaced with the appearance of newer more accurate explanations.
From this perspective psychoanalysts that describe psychiatric illnesses through meta-psychological theories are making the error of epistemologically transforming this viewpoint into a comprehensive system of theory and practice which is then unable to accept any alternative or complementary viewpoints. It is also true of psychiatrists who rely on biological theories solely to explain their patients' negative and positive reactions to treatment or those who believe that theories such as neural Darwinism will eventually be able to explain the nature of their characters and even pathology eliminating any need for psychodynamic treatment.
There has been a change in the perspectives of the above analysis. However, psychotherapy treatment still battle with these perspectives. Psychoanalysts often have the worry that if medication is prescribed and the treatment they're undergoing is not psychoanalysis anymore. It is possible to consciously or unconsciously result in a reluctance to take medications in cases where there is an obvious reason to look into a trial medication. Another risk for analysts is to give too much importance on the significance of symptoms instead of the concept of phenomenology when making medical decisions.
