The dynamic psychiatrist: internist of the mind

Abstract As dynamic psychiatrists our main clinical focus is to understand patients' symptoms and character structure through the exploration of their past and present experiences. This occurs within the context of their biopsychosocial environment. We work with tools such as free association, interpretation of transference distortions, and resistance to retrieving unconscious experiences. Yet, in the past 30 years our understanding of the role of the therapeutic relationship and other curative factors has changed. Through personal experience, the author explores these matters, considering more active participation in the treatment sessions, flexible frequency of meetings, modified use of therapeutic techniques, variable length of treatments, and concomitant use of psychotropic medication. More than in the past, the practice of the dynamic psychiatrist is modeled on that of the internist-a physician who integrates into his/her clinical work the current understanding of the function of the brain. The dynamic psychiatrist actively participates in the resolution of a given symptom picture and fosters improvement of the patient's personality structure to maximize functioning.