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Integrating Theoretical Paradigms

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Difficult Psychiatric Consultations

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Abstract

In this chapter, we have provided a foundation to better comprehend the importance that innate biological and genetic processes have in forming a patient’s unique core sense of self, as well as their intrapsychic and interpersonal psychological functioning. With a greater grasp of these concepts, the consulting psychiatrist can begin to use the psychodynamic tenets to understand the patient’s personality style and may develop a psychodynamic formulation, regardless of his or her theoretical orientation, to facilitate the implementation of practical treatment interventions in difficult consultations.

Some readers may feel that this chapter is heavy-handed with psychodynamic theory and not attachment theory, while others may feel that there is not sufficient emphasis of classic psychodynamic theory and too much on contemporary attachment theory. It is not our aim in this book to provide an in-depth analysis of the similarities and differences between each very useful theory. Rather, we hope to provide an easy way to employ, in a practical sense, each theory as it pertains to the patient, family , and treatment-team members psychodynamically. When the interaction between patient and others is approached in a psychodynamic way, a balanced framework results—a framework that can be easily explored within the short time period that the consulting psychiatrist or child psychiatrist usually has to devote to his or her cases, whether or not they are difficult consultations.

The poor ego has a still harder time of it; it has to serve three harsh masters, and it has to do its best to reconcile the claims and demands of all three. . . . The three tyrants are the external world, the superego , and the id

—Sigmund Freud (1856–1939)

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Authors and Affiliations

  1. Department of Psychiatry and Child Psychiatry, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA

    Sergio V. Delgado

  2. Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA

    Jeffrey R. Strawn

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  1. Sergio V. Delgado
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  2. Jeffrey R. Strawn
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Delgado, S.V., Strawn, J.R. (2014). Integrating Theoretical Paradigms. In: Difficult Psychiatric Consultations. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39552-9_2

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  • DOI: https://doi.org/10.1007/978-3-642-39552-9_2

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