Issues in the Psychodynamic Treatment of Patients with Attention Deficit Hyperactivity Disorder
Speaker: Stephen Bernstein, M.D.
November 17 at 8:30 am - 12:00 pm
Most therapists are now treating or can expect to treat adult patients with cognitive deficits such as attention deficit hyperactivity disorder (ADHD), based on the prevalence of this syndrome in children and its continuation into adulthood. ADHD is a cognitive disorder considered to be a dysfunction of affect regulation and behavioral inhibition. Manifestations of ADHD can mimic the clinical expression of intrapsychic conflict, in which the cognitive deficits are embedded. If these symptoms are interpreted primarily as transference resistances without acknowledging the cognitive contribution, the patient may experience a resurgence of feeling misunderstood and shamed, helpless and defective. Confusion in the countertransference is a hallmark of treatments in which cognitive deficits are intertwined with psychic conflict. A variety of technical considerations and confusions in the countertransference will be illustrated in a case presentation.
1.Describe the manifestations of Attention Deficit Hyperactivity Disorder (ADHD), and how these can mimic the clinical expression of intra-psychic conflict, in which the cognitive deficits are embedded.
2. Show how confusion in the countertransference is a hallmark of treatments in which cognitive deficits such as in ADHD, are intertwined with psychic conflict.
3. Explain how the cognitive deficits of ADHD have shaped developmental deficits, conflicts, and compromise formations, and often require technical adaptations in the therapeutic frame in order to bring about change.
Dr. Stephen B. Bernstein graduated from Franklin and Marshall College, New York Medical College, and was a Psychiatric Resident and Chief Resident at the McLean Hospital division of the Massachusetts General Hospital. For two years he was the Chief of the Early Clinical Drug Evaluation Unit of the Psychopharmacology Research Branch of the National Institute of Mental Health, prior to becoming the Director of the Psychiatric Inpatient and Day Hospital Services of the Tufts New England Medical Center for ten years. He trained in psychoanalysis at the Boston Psychoanalytic Institute where he is past Chair of the Education Committee, and is Training and Supervising Analyst. He is a Clinical Professor of Psychiatry at the Tufts University of Medicine.
Dr. Bernstein has published over 25 scholarly articles in journals such as: The New England Journal of Medicine, The American Journal of Psychiatry, and the Journal of the American Psychoanalytic Association. He published the first article on the transition for therapy to analysis with the same analyst (1983) as well as several others on that subject (1990, 2000, 2010). He has recently published an article on the treatment of adult patients with Attention Deficit Hyperactivity Disorder (2015). He has a long term interest in helping therapist and analysts learn about out their treatments by writing about their clinical experience and has published several articles on the subject. (1992, 2007, 2008)
Dr. Bernstein practices Psychotherapy, Psychoanalysis, and Supervision/Consultation in Brookline, Massachusetts.
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