Customer Service | Help | FAQ | PEP-Easy | Report a Data Error | About
:
Login
Tip: You can request more content in your language…

PEP-Web Tip of the Day

Would you like more of PEP’s content in your own language? We encourage you to talk with your country’s Psychoanalytic Journals and tell them about PEP Web.

For the complete list of tips, see PEP-Web Tips on the PEP-Web support page.

Blackman, J.S. (2003). Dynamic Supervision Concerning A Patient's Request for Medication. Psychoanal Q., 72(2):469-475.

(2003). Psychoanalytic Quarterly, 72(2):469-475

Dynamic Supervision Concerning A Patient's Request for Medication

Jerome S. Blackman, M.D., F.A.P.A.

During supervision, a psychiatry resident casually mentioned her response to a depressed patient's request for a change of antidepressant: she prescribed a new one. Should this have been the cause for supervisory intervention?

This is a difficult question. The prescription of antidepressant medication is routine and normative in current mental health practices. Psychiatrists regularly prescribe SSRIs for depressed and anxious patients, and psychoanalysts routinely prescribe for depressed analysands or refer them for medication. Medication is a first-line treatment for depression and anxiety, recommended by psychiatric textbooks and by the American Psychiatric Association (2002).

In this climate, it is a challenge for a psychoanalytic supervisor and a trainee involved in treating a patient dynamically to consider possible antitherapeutic elements of complying with the patient's request. To look at the prescription of medication as a countertransference compromise formation seems almost anachronistic (Blackman 2003). Nevertheless, the following supervisory sessions with Dr. X, a psychiatry resident at Eastern Virginia Medical School, led to some possibly instructive discoveries regarding her patient's request and her response to it.

Dr. X's Treatment of Mr. A

Mr. A, a 37-year-old, married man, entered treatment for depression due to confusion over his infidelity during his marriage.

[This is a summary or excerpt from the full text of the book or article. The full text of the document is available to subscribers.]

Copyright © 2020, Psychoanalytic Electronic Publishing, ISSN 2472-6982 Customer Service | Help | FAQ | Download PEP Bibliography | Report a Data Error | About

WARNING! This text is printed for personal use. It is copyright to the journal in which it originally appeared. It is illegal to redistribute it in any form.