An outcome of psychodynamic psychotherapy: a case study of the change in serotonin transporter binding and the activation of the dream screen.
ABSTRACT We explored the outcome of psychodynamic psychotherapy of a female patient with major depression using clinical evaluation and serotonin transporter (SERT) binding assessed with [123I]nor-beta-CIT SPECT. The psychotherapy process was analyzed with special emphasis on the change that was recognized in the dreaming process. The activation of the dream screen in transference seemed to form a turning point during the psychotherapy. Normalization of SERT binding at the midbrain level was found on 12-month follow-up. Major alleviation of depressive symptoms assessed by rating scales was evident only six months after SERT normalization.
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ABSTRACT: The paper focuses on the essentials of psychoanalytic process and change and the question of how the neural correlates and mechanisms of psychodynamic psychotherapy can be investigated. The psychoanalytic approach aims at enabling the patient to "remember, repeat, and work through" concerning explicit memory. Moreover, the relationship between analyst and patient establishes a new affective configuration which enables a reconstruction of the implicit memory. If psychic change can be achieved it corresponds to neuronal transformation. Individualized neuro-imaging requires controlling and measuring of variables that must be defined. Two main methodological problems can be distinguished: the design problem addresses the issue of how to account for functionally related variables in an experimentally independent way. The translation problem raises the question of how to bridge the gaps between different levels of the concepts presupposed in individualized neuro-imaging (e.g., the personal level of the therapist and the client, the neural level of the brain). An overview of individualized paradigms, which have been used until now is given, including Operationalized Psychodynamic Diagnosis (OPD-2) and the Maladaptive Interpersonal Patterns Q-Start (MIPQS). The development of a new paradigm that will be used in fMRI experiments, the "Interpersonal Relationship Picture Set" (IRPS), is described. Further perspectives and limitations of this new approach concerning the design and the translation problem are discussed.Frontiers in Human Neuroscience 01/2013; 7:355. · 2.90 Impact Factor
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ABSTRACT: We present a review of several hypotheses concerning the possible neurobiological correlates of the main processes involved in analytic therapy. Attachment theory may represent an interesting link between psychoanalysis and neurobiology. According to Bowlby's conception, interactions with parental figures during infancy lead to the formation of an "internal working model." This determines how the individual will relate with others and cope with stress throughout life. The patterns formed are in many cases pathological. The internal working model is stored as implicit memory, which is expressed independently of consciousness. Clinical improvement in analytic therapy ultimately depends on changes in the implicit memory system, which entails structural brain modifications. Implicit memory system changes may be related to alterations in explicit memory systems, which result from interpretative work. They may also occur directly as a result of the emotional experiences in the patient-analyst relationship.Psychology and Neuroscience 12/2011; 4(3):417-427.
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ABSTRACT: Brain imaging studies have demonstrated that psychotherapy alters brain structure and function. Learning and memory, both implicit and explicit, play central roles in this process through the creation of new genetic material that leads to increased synaptic efficiency through the creation of new neuronal connections. Although there is substantial evidence supporting some of the neurobiological effects of psychotherapy in adult patients, little exists on the impact of psychotherapy in children. Research has supported the enduring effects of early childhood trauma as represented by alterations in stress response, for example, which has important implications for early intervention through psychotherapy. Presently, the major questions facing the field of child and adolescent psychotherapy are identical to those in the study of adults. These can be reduced to four questions: what type of therapy, for what type of problem, in what type of child, and by what type of therapist. Areas needing further research are discussed.Journal of Loss and Trauma 06/2009; 14(4). · 1.03 Impact Factor