Outlook: Neuropsychodynamic Psychiatry and the Impact of Therapeutic Relationships
The neuropsychodynamic approach has far-reaching implications for how mental phenomena, like the self, the conscious, the unconscious and their underlying psychological functions, are viewed. Mental phenomena are considered in a relational perspective, taking the relationships between the self, brain and environment as a starting point. What has historically been attributed to the mind, and in more modern times frequently to the brain as basic content, can, we believe, only be understood as part of this self-brain-environment relationship. This relationship is of a primary nature, and what is individually described and perceived as the self, the brain or the environment is precisely a result of this basic, fundamental relationship.
Psychiatric disorders may be characterised by shifts or an imbalance in the self-brain-environment relationship. The chapters in this book have taken on the challenge of endeavouring to bridge the principal differences between a person’s individual level and the brain’s general level. Neuroscientific results are examined in light of the essentials of psychodynamic psychiatry, and their epistemological and clinical significance is highlighted in the relevant chapters.
Neuropsychodynamic psychiatry is presented in this book as a diagnostic and therapeutic approach for our present day. At the same time, neurodynamic psychiatry is also a scientific model for the future: it focuses on explaining, understanding, researching, diagnosing and treating psychopathological phenomena and includes dilemmata and distortions in intrapsychic structures and internalised object relationships. This means that the functionality and dysfunctionality of psychic and neuronal mechanisms can be taken into account and put into the context of neuronal correlations.
From a methodological perspective, we are confronted with the claim that neuropsychodynamic psychiatry should be bilingual, understanding and speaking the language of the brain and that of the mind: we feel that neuropsychodynamic psychiatry can contribute to overcoming deep-rooted dichotomies surrounding somatopsychic-psychosomatic phenomena.
The authors hope that neuropsychodynamic psychiatry, as outlined in this book, will help scientific and clinical “relationship work” to come together.
- Freud S. Mourning and melancholia. Standard Edition, Vol. XIV. London: Hogarth; 1914–1916. p. 237–260.Google Scholar
- Mentzos S. Lehrbuch der Psychodynamik. Die Funktion der Dysfunktionalitat psychischer Störungen. 5th ed. Göttingen: Vandenhoeck & Ruprecht; 2011.Google Scholar
- Boeker H, Northoff G. Die Entkopplung des Selbst in der Depression: Empirische Befunde und neuropsychodynamische Hypothesen. Psyche Z Psychoanal. 2010;64:934–76.Google Scholar