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Published on: April 29, 2007
The analyst's attitude toward pharmacotherapy
1San Francisco Center for Psychoanalysis, Psychoanalytic Institute of Northern California, San Francisco, CA 94115, USA. purcellsd@comcast.net
Abstract:
The increased acceptance of medication in psychoanalysis has occurred with too little consideration of possible complications. The potentially adverse psychological effects and disintegrative aspects of this important technical modification require further examination. While the use of phenomenologically defined diagnostic criteria provides valuable guidance to the clinician, the decision to include pharmacotherapy in a psychoanalysis must be understood also as a transference-countertransference enactment. The analyst's attitude toward pharmacotherapy is an essential element in some defensive and gratifying enactments, resistances that can interfere with psychoanalytic processes. Clinical material is presented illustrating narcissistic and perverse resistances that might be facilitated by analysts' attitudes toward pharmacotherapy, attitudes often tacitly communicated in decisions to use combined treatment.
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