On the Birth of Psychodynamic Psychiatry.

Psychodynamic psychiatry emerged from psychoanalytic theory, but the influence of the latter has been only partial. Equally important are other disciplines outlined within is article. Modern psychodynamic publications and presentations should honor all of the foundational pillars of the field. In this way, the new area lends itself to bio-psycho-social integrations that remain a challenge for all researchers and clinicians who seek to understand and treat patients with mental disorders.

Editorial: Therapeutic Factors in Treatment of Patients with Borderline Personality Disorder.

In this issue of Psychodynamic Psychiatry, Michael Stone discusses therapeutic factors in the treatment of patients with Borderline Personality Disorder (BPD). He emphasizes the great diversity of borderline patients and points out that a number of manual-based therapies, each described by an acronym, generally achieve positive therapeutic results in the short term. Many borderline patients require years of psychotherapy, pharmacotherapy and additional treatments, however. Stone observes that patients with this disorder invariably have other personality characteristics and disorders. Suicidality is common among borderline patients, particularly those who also suffer from major depressive episodes. Stone emphasizes the usefulness of a contextual therapeutic model and a flexible clinical stance.

Comparison of Sexual Experience and Behavior between Bipolar Outpatients and Outpatients without Mood Disorders.

Sexual behavior over the past year of 32 outpatients with Bipolar disorder is compared to that of 44 Comparison patients that had never had an episode of affective illness. Subjects were outpatients treated with drugs and psychotherapy in routine office practice. Differences in sexual behavior between the two groups as a whole were minimal, but meaningful differences emerged when subgroups were compared. Compared to control men, Bipolar men had had more partners in the last year and were more likely to have had sex without condoms. Compared to Bipolar females, Bipolar males had more sex partners, had more sex with strangers, and were more likely to have engaged in homosexual behavior. Even so, some patients in the Comparison group also had engaged in risky sexual behavior. They had failed to use condoms and had had sex with strangers and prostitutes during the previous year.

Sexual differentiation of childhood play: a contemporary psychoanalytic perspective.

Freud (1905/1953) anchored his theories of unconscious psychological functioning in observations and inferences about childhood sexuality. These ideas remain influential among psychoanalysts today. Much progress subsequently occurred in extra-psychoanalytic research in human sexuality. This included the discovery in 1959 of an entirely new area of psychology: the sexual differentiation of behavior (Phoenix, Goy, Gerall, & Young, 1959; Wallen, 2009). The observations that led to this new field originally concerned the effects of androgen administered prenatally to non-human animals. This early research was compatible with later studies of humans as well. Prenatal androgen influences both erotic and non-erotic behavior, including childhood rough-and-tumble play (RTP). We have previously emphasized the need to integrate this psychoneuroendocrine knowledge with psychoanalytic theory and practice (Friedman, 1988; Friedman & Downey, 2002, 2008a, 2008b). In this article, we discuss additional aspects of the relationship between sexually differentiated childhood play, particularly RTP, and gender differences in psychosexual development and functioning. These topics and other aspects of the sexual differentiation of behavior have been under-emphasized in psychoanalytic thought.