TY - CHAP M1 - Book, Section TI - Psychodynamic Psychotherapy and the Therapeutic Relationship A1 - Lomax, James W. A1 - Ivan, Mihaela Cristina A2 - Ebert, Michael H. A2 - Leckman, James F. A2 - Petrakis, Ismene L. PY - 2019 T2 - Current Diagnosis & Treatment: Psychiatry, 3e AB - Human beings are subject to a multitude of adverse influences arriving from both external and internal sources. These adverse influences include internal conflicts (between one's aims and goals or urges and prohibitions), interpersonal disputes, certain cognitive and/or behavioral "errors" (e.g., catastrophizing and avoidance of exaggerated anticipated danger), personal and relational loss (both loss of significant attachment figures and loss of physical or cognitive abilities through illness, injury, or aging), and sociocultural or spiritual struggles. Through psychotherapy, physicians provide assistance in the managing of suffering resulting from these adverse influences. Structured professional relationships have been developed to address each of these adversities as the different forms of psychotherapy. Psychotherapy may also be focused on modifying the patient's overall pattern of adaptation to life (or personality). As Cloninger and others (1993) have demonstrated, personality is best considered as an interactive combination of factors that are gene-based, and, therefore, relatively immutable, with factors stemming from the nonshared environment. Some of the expressive psychotherapies make modifications in "character" as defined by Cloninger, but there is relatively little that a psychological intervention can do to alter the gene-based determinants of personality. These are often conceptualized as "temperament" (novelty seeking, harm avoidance, reward dependence, and persistence). To address problems related to temperament, the psychotherapist helps the patient to accommodate to the gene-based determinants of behavior so that they become expressed in ways that create less chaos or conflict in the person's relational world. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1158258152 ER -