Psychodynamic Psychiatry Day 2023: The Science of the Art of Psychopharmacology Resources Page

Royal College of Psychiatrists
21 Prescot Street
London
E1 8BB

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Please read the vignette (PDF) in advance of attending the conference.

We will be breaking into smaller groups during the afternoon session to discuss this case.

Tennyson Lee is a consultant in General Adult Psychiatry and Medical Psychotherapy and a psychoanalyst. He is clinical lead at DeanCross Personality Disorder Service (RCPsych team of the year in 2019) in the East London NHS Foundation Trust. He is co-director of the Centre for Understanding of Personality (CUSP), and chair of Transference Focused Psychotherapy-UK. He is a founder member of the Psychodynamics of Prescribing - UK Group.

David Mintz, M.D. is the Director of Psychiatric Education and Associate Director of Training at the Austen Riggs Center in Stockbridge, Massachusetts.

A psychodynamic therapeutic community specializing in the treatment of patients who are complex, co-morbid, and treatment refractory. To address the treatment needs of these patients, Dr. Mintz and colleagues developed a psychodynamically-informed, patient-centered model for addressing psychological and interpersonal complications with the patient’s healthy use of pharmacotherapy. His book Psychodynamic Psychopharmacology: Caring for the Treatment-Resistant Patient, and dozens of other publications, explores these principles. Dr. Mintz is also the recent past Leader of the Psychotherapy Caucus of the American Psychiatric Association.

David Rogalski, General Pharmaceutical Council, Royal Pharmaceutical Society,College of Mental Health Pharmacy

David Rogalski is a senior pharmacist and independent prescriber working in single point of access mental health team in an inner city London, where he has been developing a relational approach to prescribing with multidisciplinary team members. He has expertise in medicines safety, overprescribing, and guideline development. He is a founding member of PoP-UK and co-author of the paper ‘Will this tablet make me happy again? The contribution of relational prescribing in providing a pragmatic and psychodynamic framework for prescribers’. He has a teaching and research interest in psychopharmacotherapy and relational prescribing presenting at national and international conferences.

The Psychodynamics of Pharmacologic Treatment Resistance - Dimitrios Chartonas and David Rogalski 

Dimitrios Chartonas and David Rogalski will be giving this joint presentation on the psychodynamics of pharmacologic treatment-resistance. We will be covering three main types of treatment resistance, namely resistance to medication, resistance from medication, and clinician's resistance, including systemic and cultural factors. We will be focusing in particular on the complexities of the patient's ambivalence, counter-therapeutic use of medication, and counter-transference prescribing. We will use brief case vignettes to illustrate some of our ideas. Our presentation will attend to psychological aspects of pharmacological treatment resistance drawing on psychodynamic theory. We consider the problems of adherence, overprescribing and deprescribing as problems of resistance to treatment. We examine the different types of treatment resistance, namely resistance to medication, resistance from medication, clinicians’ resistance and resistance associated with systemic factors. We discuss the complex phenomena of ambivalence to treatment, countertherapeutic uses of medication and countertransference, and their place in the pharmacotherapeutic relationship and the acts of prescribing and taking medication. 

The Science of the Art of Pharmacotherapy - Dr David Mintz

Much attention has been paid to “evidence-based practice” in psychiatry, but, for the most part, this has meant a focus on what to prescribe. There is a substantial, but oft neglected, evidence base that deals with psychosocial aspects of prescribing that will be addressed in this talk, providing guidance on how to prescribe. This presentation will address what is known about the impact of meaning on medication and psychosocial aspects of effective prescribing process, allowing participants to better integrate the 2 evidence bases (biomedical with psychosocial) to enhance treatment outcomes.

• Update from Dr Jo O'Reilly, Faculty Chair (PDF)
• Psychodynamics of pharmacologic treatment-resistance (PDF) - David Rogalski and Dr Dimitrios Chartonas
• Technical principles of psychodynamic psychopharmacology and a framework for reflection (PDF) - Dr Haroula Konstantinidou - Contact at haroula.konstantinidou1@nhs.net to discuss any projects in your workplace

Copies of the PowerPoint presentations are available by kind permission of the presenters. If a presentation is not listed, it is because we have not received permission from the author. All presentations remain the intellectual property of the author and it is strictly prohibited to copy, distribute or reproduce any information, images or data included in these presentations without the prior written consent of the author.

This conference is eligible for up to six CPD hours, subject to peer group approval.

Certificates of attendance will be sent via email within one week of the conference.

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