• Title/Summary/Keyword: Psychodynamic treatment

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Psychodynamic Psychotherapy of PTSD (외상 후 스트레스 장애의 역동정신치료)

  • Kim, Jung-Young;Park, Jong-Il;Yang, Jong-Chul
    • Anxiety and mood
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    • v.11 no.2
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    • pp.106-113
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    • 2015
  • In psychodynamic therapy, trauma related symptoms are considered as an attempt to overcome the traumatic experiences. Therefore, psychodynamic psychotherapy regards the symptom not as a patient's defect but as an adaptive reaction. In contrast to other therapies, psychodynamic theory places heavy emphasis on the understanding and resolution of the patient's symptoms. In addition, transference is a distinctive feature of this theory, which plays a significant role of reflecting the realistic evaluation on the therapist's characteristics, and in guaranteeing the therapeutic alliance. The psychodynamic therapist inducts meaning from the patient's unconscious mind. The therapist's task is to help the patient to better understand defense mechanisms guide their management of experiences and reactions, and facilitate a better understanding of their personal experiences.

A Study on The Oriental-medical Understanding of Depression (우울증(憂鬱症)의 한방적(韓方的) 이해(理解)에 관한 문헌고찰(文獻考察))

  • Jang Hyun-Ho;Kang In-Seon;Moon Hyung-Cheol;Hwang Yoo-Jin;Lyu Yeoung-Su;Kang Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.12 no.2
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    • pp.1-15
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    • 2001
  • According to ICD-10, The typical Depression are characterized by dejected mood, loss of interest and pleasure, feeling of helplessness. Also, other symptoms such as loss of attentiveness and concentration, guilty conscience, pessimistic attitude for the future, sleeping disorder, lack of appetite, thinking of or doing a self-injury or suicidal act may characterize Depression. These Symptoms of Depression are similar to Wool-Zeng(鬱證), Zeon-Zeng(癲證), Her-ro(虛勞), Bul-Sa-Sik(不思食), Tal-Young-Sil-Zeong(脫營失精), Bul-Myeon(不眠), Ki-Myeon(嗜眠) in Oriental Medicine. In general, Depression is classified into Wool-Zeng type and Zeon-Zeng type. The former is similar to the neurotic type of depression, the latter is similar to the psychopathic type of depression. The clear causes of Depression are not known yet. But psychodynamic and biological factors are assumed to cause Depression. Psychodynamic factors may correspond to Chil-Zeong(七情) and biological factors to Tae-Byeong(胎病) and Dam(痰) in Oriental medicine. In Occidental medicine, Depression is treated by psychotherapy and medication. Electrically-induced spasm therapy and phototherapy also used for the treatment of Depression. In Oriental medicine, Depression is treated by more various therapy such as herb medication, acupuncture and moxibustion, oriental psychotherapy and dirigation(Gi-Gong, 氣功). Depression is not easy to cure. When the treatments of Occidental medicine and Oriental medicine are mutually cooperated, more effective medical care might be expected. Therefore, futher study to treat depression by mutually cooperated therapy is necessary.

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Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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The Relationship between Psychotherapy and Neurobiological Findings (정신치료와 신경생물학적 연구결과의 관계)

  • Oh, Hyun-Young;Park, Yong-Chon
    • Korean Journal of Biological Psychiatry
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    • v.19 no.1
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    • pp.1-8
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    • 2012
  • The mechanism of psychotherapy is explained by the recent developments in neuroscience and neuroimaging. The purpose of this study is to understand the nature of psychotherapy and to discuss the future of psychotherapy improvement with the help of advances of the neurobiological findings in psychotherapy. For this study, we investigated a wide range of materials. We searched for various researches on psychotherapy, brain, and neurobiology. In addition to the conventional psychodynamic psychotherapy, we investigated research findings on cognitive behavioral therapy, interpersonal psychotherapy and eye movement desensitization and reprocessing (EMDR). Moreover, based on the actual experiences of treating patients, we speculated the neurobiological mechanisms of the process and results of psychotherapy. With the development of neuroscience, we are now able to understand the personal consciousness, unconsciousness and developmental process. Also subdividing the disease is made possible. Personalized treatment has become available, and we are able to predict the prognosis of patients. Our memories are composed by implicit memory and explicit memory. By psychotherapy, we can consciously remember explicit memory, and it becomes easier to explore implicit memory through free association. Through psychotherapy, we will also be able to learn the effect of acquired environment and experience. Psychotherapy is able to correct human behaviors by modifying the memories. Through the regulation of emotions, it becomes possible to modify the memories and correct the behaviors. In this process, doctor-patient relationship is the main factor which cause positive treatment effects. Furthermore imagination therapy or unconscious, non-verbal stimuli could bring about positive treatment effects. Now psychotherapy could be explained and studied by neuroscientific researches. In this sense, we could provide the direction of future advances in neuroscience by the neurobiological understanding of psychotherapy.

Self Care in Depression (우울증의 자기 관리 방법)

  • Lee, Sun-Hea;Park, Yong Chon
    • Korean Journal of Biological Psychiatry
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    • v.14 no.1
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    • pp.5-13
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    • 2007
  • Objectives : Depression disturbs the individual life from the loss of productivity to suicide. Furthermore the whole society is also influenced by depression in social and economic areas. Many scientific treatment methods are known to be effective in depression. But in reality more than half of patients with depression prefer self help treatment rather than medically based treatment. For the patients with mild depression and primary physicians, it is reasonable to provide the evidence based self care including self help or alternative treatment. This study is supported by the Korean Health 21 R&D Project for the Depression Center to establish the Korean treatment guideline for depression. Methods : The members of Depression Center including the authors attended the workshops where the methods of evidence based medicine such as literature search, quality evaluation of the articles, making the level of evidence were educated. The professional librarians helped the authors for get the searched articles. Among the total of 354 abstracts of systemic review and 300 abstracts of random controlled trials, 3 systemic reviews and 2 random controlled trials were the main structure of evaluation. Result : Among the 37 self care methods known to be effective for depression, 11 kinds of methods were worth of evaluation. The first step for the self care of mild depression is to use St. John's wort, exercise, bibliotherapy, and light therapy in depression during winter season. Acupuncture, negative ion therapy, massage, relaxation technique are known to be efective with evidence. Music therapy, hypnotherapy, and aromatherapy are known to be effective but until now the evidences is insufficient and further evaluations are needed. Conclusion : Among 11 listed self-care methods, several methods need more evidence especially in Korean situation. Exercise is the most recommendable evidence based self care method in Korea nowadays. St. John's wort is effective with evidence, but it is not the OTC drug in Korea, so it is not recommendable now. For the bibliotherapy, there is no book such as "Feeling Good" in Korea. Only the introductory book about depression is available. Publishing the self help book based upon cognitive behavioral approach or psychodynamic approach is needed. Light therapy is practiced in a few clinics, but not self-help style. Exposure to the sunlight is recommended in the level of commen sense. These self care methods are for the mild patient. Moderate to severe patients with depression should seek the professional treatment.

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Current Situation of Psychiatry in North Korean : From the Viewpoint of North Korean Medical Doctors (북한 의사들이 바라보는 북한의 정신의학 현황)

  • Kim, Seog-Ju;Park, Young-Su;Lee, Hae-Won;Park, Sang-Min
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.32-39
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    • 2012
  • Objective : Psychiatry in North Korea is believed to seem very different from psychiatry in South Korea. However, there is nearly no information regarding psychiatry in North Korea until now. Our study aimed to get information about North Korean psychiatry. Methods : Three North Korean defectors in South Korea, whose clinical experience as medical doctors in North Korea was over 10 years, were recruited. They underwent the semi-structured interview, content of which included the clinical experience with psychiatric patients, the details of psychiatry, the treatment of psychiatric patients, the stigma of mental illness, and the suicide, in North Korea. Results : In North Korea, psychiatric department was called as 49th(pronounced as Sahsip-gu-ho in Korean). Only patients with vivid psychotic symptoms came to psychiatric department. Non-psychotic depression or anxiety disorders usually were not dealt in psychiatry. The etiology of mental illness seemed to be confined to biological factors including genetic predisposition. Psychosocial or psychodynamic factors as etiology of mental illness appeared to be ignored. Psychiatry was apparently separated from political or ideological issues. The mainstay of psychiatric treatment is the inpatient admission and out-of-date therapy such as insulin coma therapy. Stigma over mental illness was common in North Korea. Suicide is considered as a betrayal to his/her nation, and has been reported to be very rare. Conclusion : The situation of psychiatry in North Korea is largely different from that of South Korea. Although some aspects of North Korean psychiatry are similar to psychiatry in former socialist countries, North Korean psychiatry is considered to have also its unique characteristics.

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EFFECTS OF GROUP THERAPY ON SPEECH FLUENCY IN ELEMENTARY SCHOOL STUTTERING CHILDREN (학령기 말더듬 아동 치료에 있어 그룹지도의 효과)

  • Shin, Moon-Ja
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.102-115
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    • 1991
  • This study reviewed the stuttering literature and reported the clinical experiment in stuttering intervention. There is still no single answer as to the cause of stuttering or to the most effective therapy for stutterers despite the vast amount of research. One certain thing is that we have come closer to a better understanding of the stuttering and to more effective therapy. There have been three main statements about the origins of stuttering ; biologic origins ; psychodynamic origins ; environmental-learning origins. There also have been various methods of the treatment of stuttering. Broadly, two major treatment approaches are attentive ; stuttering modification therapy and fluency shaping therapy. In this experiment, the researcher attempted to investigate complex elements that each child might have and to use an integrative approach rather than to keep the specific one. Individual subjects were evaluated by a multidisciplinary team. Initially, the subjects received individual therapy. They then were placed in group therapy. The purpose of the group therapy was to raise their fluencies to the higher communicative situation and to maintain improved fluency over time. All three subjects improved their fluencies in reading and in conversation and showed the better(SSI)scores in total stuttering behaviors. It was also discussed that it is necessary to have sensitive assessment tools to investigate each element of stuttering ; and to develop a therapy program reflecting current advanced stuttering theories.

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Somatic Symptoms after Psychological Trauma (심리외상 이후의 신체증상)

  • Park, Joo Eon;Ahn, Hyun-Nie;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.43-53
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    • 2016
  • Objectives : Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. Methods : This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. Results : The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. Conclusions : Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.

Biological Mechanism of Somatization : Mainly Focused on the Neuropsychological Model of Somatization (신체화의 생물학적 기전 : 신체화의 신경심리학적 모델을 중심으로)

  • Lee, Young-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.122-140
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    • 2000
  • Somatization disorder is a chronic condition characterized by multiple somatic complaints that are not due to any apparent organic illness. Somatization disorder is related historically to hysteria and hysteria has been defined by the existence of somatic complaints for which no organic reason can be found. Therefore most theories of somatization have focused on the psychodynamic and sociological perspectives. However, the concept that the somatic presentation of emotional distress or psychiatric illness might have a neurobiological basis has also aroused considerable interest. Relative to this perspective, the case of Anna O. which has been considered the prototype of hysteria, was reformulated from a neuropsychological perspective. Several neurophysiological and neuropsychological studies, studies concerning hemispheric differences in symptom presentation of the patients with hysteria have been shown the evidences for the biological basis of somatization. Moreover, recent neuroimaging studies in somatization disorder also show that brain dysfunction in somatization. The author reviewed several candidate theories which could help to explain the process of somatization in the perspective of biological basis and proposed the new neuropsychological model of somatization. The author also examined the possible application of this model to the treatment of somatization disorder and discussed it's limitation and the future directions in this field.

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