Future Prospects

The controversy regarding the use of medication with psychoanalysis or psychodynamic psychotherapies may someday seem quaint and misguided, much like the concept of the "refrigerator mother" causing schizophrenia in her child. Psychotropic medications are both an enormous boon to those of us who strive to relieve suffering and distressingly nonspecific in their capacity to manipulate psychological processes even as we come to understand these processes at neurochemical and neurophysiological levels of analysis. New medications are constantly being introduced and the monoamine theory will be supplanted with more sophisticated approaches over time. Our understanding of pharmacodynamics (the specific ways that drugs interact at receptor sites in individuals) and pharmacogenomics (the genetic patterns that affect how individuals respond to drugs) will eventually make prescribing medication for a given individual a far more accurate procedure. Genetic engineering (the insertion of genetic material necessary to cure a disorder) may someday make drug treatment unnecessary for certain illnesses, but given the huge complexity of psychiatric disorders that involve mood, affect, cognition, and behavior, specific genetic causes for most psychiatric illnesses will be difficult to identify. The role of life events in the etiology and progression of psychiatric disturbances must not be minimized.

The SSRIs opened the way to a new conceptualization of depression as a medical illness that can be treated much like diabetes can be treated with insulin, but psy-chodynamically oriented psychopharmacologists know this is far from either a simple or adequate solution. In fact, whether treating depression or diabetes, the relationship with the doctor is primary and remains a key to optimal therapeutic practice. Medications often have variable effectiveness; it is the medication plus the relationship that sustains well-being. Psychoanalysts understand and accept this principle, and those who are interested in working with medications (whether prescribed by themselves or others) while remaining open-minded about theory are commonly the most effective. Psychoanalysis has much to gain from investigation of growing knowledge from the neurosciences about brain function, and psychoanalytic theory can continue to evolve to take account of these advances (Solms and Turnbull, 2002).

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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