General Principles of Psychodynamics

r sychiatry is the medical specialty that studies disorders of behavior and experience, both affective and cognitive. Like other branches of medicine, it considers 1) the phenomenology of the normal and abnormal, 2) systems of classification and epidemiological information, 3) etiology, 4) diagnosis, and 5) prevention and treatment. Because human behavior is complex, psychiatry draws on many fields of knowledge, ranging from biochemistry, genetics, and neuroscience to psychology, anthropology, and sociology, in order to understand its subject matter. The interview is a basic technique of psychiatry and most other clinical specialties. Other methods may also be employed, such as biological or psychological tests, symptom rating scales, or pharmacological or physical treatments, but even these usually occur within the context of a clinical interview. The psychiatric interview is by far the most important diagnostic tool of today's psychiatrist. With our current knowledge, physiological and biochemical studies of behavior offer little assistance in understanding interviews, whereas psychodynamic concepts have proved valuable. In the psychodynamic frame of reference, behavior is viewed as the product of hypothetical mental processes, wishes, fears, emotions, internal representations, and fantasies and the psychological processes that regulate, control, and channel them. Subjective experience, thoughts, and feelings are of central importance, and overt behavior is understood as the product of inner psychological processes that can be inferred from the patient's words and acts. A psychodynamic formulation offers a description of mental experience, underlying psychological processes, their hypothetical origins,