ABSTRACT
The emotional pressure and transferences of patients to their physicians and other caregivers are natural, inevitable occurrences that are not restricted to therapeutic situations in which one is using a dynamic approach. Transferences are present in all relationships but are scrutinized in intensive dynamic psychotherapy. This article presents clinical examples that illustrate the intense pressures, often near-psychotic, exerted by certain borderline patients, which are unconsciously targeted to force a specific type of response from the therapist.
Subject(s)
Borderline Personality Disorder/therapy , Countertransference , Adult , Borderline Personality Disorder/psychology , Case-Control Studies , Humans , Middle Aged , Psychotherapy , Transference, Psychology , Treatment Failure , Treatment OutcomeABSTRACT
Traumatic war neurosis may become a chronic, debilitating condition that resists treatment interventions. Five patients with traumatic war neurosis had favorable therapeutic responses to phenelzine sulfate. These patients did not respond to multiple previous therapeutic trials with antipsychotics, tricyclic antidepressants, and psychotherapy with or without medication. With phenelzine, the patients felt calmer and stopped having nightmares and flashbacks of traumatic war material. Startle reactions and aggressive, violent outbursts also ceased.
Subject(s)
Combat Disorders/drug therapy , Phenelzine/therapeutic use , Stress Disorders, Post-Traumatic/drug therapy , Adult , Chronic Disease , Combat Disorders/diagnosis , Humans , Male , Middle Aged , Sleep, REM/drug effectsABSTRACT
Patients and staff may have difficulty facing the realities of a dangerous situation on an inpatient service. The authors describe how, in response to the presence of a potentially violent patient, distorted patient communications in group settings may be reinforced by staff avoidance patterns. Appropriate therapeutic interventions are often delayed until staff members overcome their resistance to acknowledging the signals that frightened patients send. The authors discuss strategies to circumvent and overcome these problems.
