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Manual of Panic-Focused Psychodynamic Psychotherapy

Barbara Milrod, M.D., Fredric N. Busch, M.D., Arnold M. Cooper, M.D., and Theodore Shapiro, M.D.

  • ISBN 978-0-88048-871-6
  • Item #8871

Description

Despite the enormous progress in the pharmacological and cognitive-behavioral treatments of panic disorder over the last 30 years, these treatments often provide only temporary or partial relief and many patients continue to experience persistent anxiety symptoms after the discontinuation of treatment. Substantial evidence exists that intrapsychic conflict and characterological features play a central role in the genesis and onset of panic disorder as well as the frequency of relapse after the termination of treatment. Many clinicians believe that psychodynamic psychotherapy is the best-suited approach to address these issues.

Based on extensive clinical experience and written by distinguished experts in the field, the Manual of Panic-Focused Psychodynamic Psychotherapy is the first manual to comprehensively examine the usefulness of exploratory psychotherapy in the treatment of panic disorder. It suggests that psychodynamic approaches can aid both psychopharmacological and cognitive-behavioral treatments and can often resolve panic symptoms in many patients when used as the sole treatment modality. The authors catalog psychological factors commonly present in panic disorder patients and describe how to address them within a psychodynamic psychotherapy. A wealth of clinical vignettes and a complete case example illustrate the psychodynamic approach to this disorder. Other treatment issues including defense mechanisms, transference, termination of treatment, and the use of this method in conjunction with other therapeutic approaches are also covered.

Contents

A psychodynamic formulation for panic disorder. Overview of treatment. Initial evaluation and early sessions. Psychodynamic conflicts in panic disorder. Defense mechanisms in panic disorder. Transference, working though, and termination. Techniques of psychodynamic psychotherapy as they apply to panic disorder. Approaches to common problems in the treatment of panic patients. Combining panic-focused psychodynamic psychotherapy with other treatment approaches. Case example: Ms. P. References. Index.

About the Authors

Barbara Milrod, M.D., is Assistant Professor of Psychiatry at Cornell University Medical College, New York, New York, and a member of the New York Psychoanalytic Society.

Fredric Busch, M.D., is Instructor of Psychiatry, Cornell University Medical College, New York, New York, and Faculty Member at the Columbia University Center for Psychoanalytic Training and Research, New York, New York.

Arnold Cooper, M.D., is Stephen P. Tobin Professor Emeritus of Consultation-Liaison Psychiatry at Cornell University Medical College, New York, New York, and Training and Supervising Psychoanalyst at the Columbia University Center for Psychoanalytic Training and Research, New York, New York.

Theodore Shapiro, M.D., is Professor of Psychiatry in Pediatrics at Cornell University Medical College, New York, New York, and Supervising and Training Psychoanalyst at The New York Psychoanalytic Institute, New York, New York.

This book launches a bold and timely riposte at what is rapidly becoming the prevailing wisdom in American psychiatry, that the treatment of axis I disorders belongs in the domain of pharmacologically and behaviorally oriented approaches rather than in that of psychodynamic therapy, where it rested for so many years. Based on a preliminary study of nine patients with panic disorder, the editors, including two prominent psychoanalysts, have produced a psychodynamic formulation applicable to many or most patients with this disorder.—American Journal of Psychiatry


There has been a disconcerting and reductionist trend in the recent psychiatric literature to regard panic disorder as a purely biological illness. The domain of psychological meaning has been stripped away and relegated to an archaic status. In this impressive new manual, four psychoanalytically trained researchers have rescued that domain from oblivion by persuasively demonstrating the value of psychodynamic conceptualization and treatment in panic disorder. They deftly integrate the biological and the psychodynamic and generously illustrate their formulations and their technique with convincing clinical examples. Psychodynamic therapy emerges as a highly effective treatment for the panic-ridden patient. This marvelous new contribution will be of great value to psychotherapy researchers studying anxiety disorders. In addition, both beginning and experienced clinicians will find the guidelines and methods extraordinarily useful in their day-to-day work.—Glen O. Gabbard, M.D., Callaway Distinguished Professor of Psychoanalysis and Education, Karl Menninger School of Psychiatry, Topeka, Kansas


This is a concise, well-written description of a novel treatment for panic disorder, and a courageous foray into disorder-focused psychodynamic psychotherapy. The ‘manual,’ based on the clinical experience and thinking of skilled psychoanalysts, presents a strategy for psychodynamic management of panic symptoms and for psychotherapeutic work aimed at reducing vulnerability to recurrent panic. Of particular interest, several of the case examples are adolescents. . . . Many will look forward with interest and excitement to results of studies using this psychodynamic treatment. . . . Most importantly, the authors draw attention to facets of panic disorder, which so far have been ignored in studies using medication and cognitive-behavioral treatments.—M. Katherine Shear, M.D., Director, Anxiety Disorders Prevention Program, Western Psychiatric Institute and Clinic, Associate Professor of Psychiatry, University of Pittsburgh School of Medicine

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