Psychodynamic Psychotherapy for Patients With Functional Somatic Disorders and the Road to Recovery, 2020, Luyten and Fonagy

[Andy]

Findings concerning the role of three related key biobehavioral systems (attachment, mentalizing, and impairments in epistemic trust) that seem to be centrally involved in FSDs, as viewed from a psychodynamic perspective, are discussed as well as empirical evidence supporting the efficacy of psychodynamic psychotherapy for patients with FSDs. Finally, the basic treatment principles of dynamic interpersonal therapy, an integrative psychodynamic treatment adapted for patients with FSDs, are outlined through a description of the treatment of a woman with chronic widespread pain and irritable bowel syndrome.

Paywall, https://psychotherapy.psychiatryonline.org/doi/10.1176/appi.psychotherapy.20200010
Sci hub, no access

 

[Sean]

biobehavioral

Is this the latest version of psychosomatic?

 

[Arnie Pye]

psychodynamic psychotherapy

Psycho twice? Isn't that overkill?

Functional Somatic Disorders

I can't help myself. Whenever I see this phrase what goes through my mind instantly is "Doctor thinks patient is lying, making things up, attention seeking, mentally ill, a hypochondriac. But the truth is the doctor's diagnostic abilities are crap."

 

[NelliePledge]

How tedious- the word salad has been tossed yet again

 

[Trish]

I've only read the abstract, but it looks like yet another brand of psychobabble therapy trying to claim they have something to offer by inventing questionnaires about vague abstracts like 'attachment, mentalizing, and impairments in epistemic trust' so they can persuade patients to answer differently about them at the end of their brand of therapy.

I do wish they wouldn't.

 

[Mithriel]

Then they say that the patients pain, fatigue movements, seizures, whatever have not changed but the patient says they feel less anxiety so it is all successful and confirms their theory.

At least I assume so since I can't access the paper.

 

[Invisible Woman]

For the love of......

Would somebody please take the Scrabble tiles off these people?

 

[Trish]

Would somebody please take the Scrabble tiles off these people?

Thanks for making me laugh.

 

[rvallee]

impairments in epistemic trust

Well ain't that a piece of very advanced bullshit. See, we don't distrust these people because they're making stuff up and are factually wrong about everything, in the process harming people. No, it's that we have an impairment in our trust in expertise. Well, in experts, because these people are, you know, making stuff up and generally wrong and as such do not have genuine expertise here.

This is the most damning thing in all of this. Explicit dissent is seen as a challenge, something that needs to be worked around. It's widely known that patients reject this astrology-level horseshit and instead of reflecting on the fact that it is based on absolutely nothing and, as such, unlikely to be accurate, they have to create a whole narrative about how we are impaired in our ability to trust them with their "expertise".

No means no. This is not a nebulous or ambiguous concept, the standard in medicine is informed consent. Explicitly, and openly, working to work around rejection of consent is just about the most immoral single thing in all of this. No matter the mediocrity and just how straight up delusional this all is, that it is accepted that consent can be ignored, even trampled over openly, guarantees the moral, and technical, failure more than anything.

It would seriously be useful for psychiatry to turn on itself for a while, to self-examine how easily they fabricate delusional fantasies despite every piece of evidence showing them they are wrong. It's a fascinating case in the failure of expertise, in hubris, in Dunning-Kruger and worse. But the field itself is incapable of self-examination and believes in the very flaws that they need to examine here. Amazing.